Integrated Care Waiver Operations Leader

CareSource; Dayton (OH); On-site; USD 94,000 - 165,000; Full time

Benefits offered by this job

Bonus potential

Total rewards package

Job summary

CareSource is seeking a Manager, Integrated Care Waiver Operations to provide leadership to operations staff and ensure compliance with Medicare, Medicaid, and state requirements. You will oversee regulatory reporting, audit readiness, and process improvements to enhance member outcomes and efficiency.

You will collaborate across Care Management, IT, Credentialing, and Provider Relations to drive coordinated care and accurate reporting, while ensuring safe, effective service delivery and strong

Responsibilities

• Lead CMS, ODM, and regulatory reporting.
• Prepare and present Medicare/Medicaid audits.
• Develop and implement action plans from regulatory feedback.
• Oversee Care Management operations and quality performance.
• Collaborate across IT, Credentialing, and Care Management teams.

Job description

CareSource is seeking a Manager, Integrated Care Waiver Operations to provide leadership to operations staff and ensure compliance with Medicare, Medicaid, and state requirements. You will oversee regulatory reporting, audit readiness, and process improvements to enhance member outcomes and efficiency.

You will collaborate across Care Management, IT, Credentialing, and Provider Relations to drive coordinated care and accurate reporting, while ensuring safe, effective service delivery and strong