Team Lead, Integrated Care Coordination - Waiver-Must live in Ohio

CareSource; Guin (AL); On-site; USD 72,000 - 116,000; Full time

Job summary

CareSource in Alabama is seeking a Team Lead for Integrated Care Coordination - Waiver to lead daily operations of Care Coordinators and manage a smaller caseload of MyCare HCBS Waiver members, ensuring compliance with regulatory standards.

You will escalate issues, provide consultation on waiver requirements, coordinate service planning, and mentor staff while collaborating with providers and internal teams to improve member outcomes.

Qualifications

• Bachelor's degree in Nursing, Social Work, Human Services, Healthcare Administration or related field preferred.
• Minimum of 3 years in care management or care coordination with waiver/Medicaid experience.
• Strong knowledge of person-centered service planning principles.

Responsibilities

• Provide day-to-day oversight and direction to assigned Care Coordinators.
• Monitor daily operational workflows and ensure timely completion of assessments, service plans, contacts, authorizations, and member outreach activities.
• Serve as the first level escalation point for staff questions, barriers, member concerns, and operational issues.
• Provide consultation regarding HCBS Waiver requirements, service planning, person-centered planning, care coordination, and service delivery.
• Assist staff with complex member situations, transition planning, service gaps, provider issues, and member health and welfare concerns.
• Support implementation of care plans and service plans in accordance with MyCare HCBS Waiver requirements.
• Assist staff with identifying community resources and supports to address member needs.
• Coach, mentor, and develop assigned Care Coordinators, providing real-time feedback and performance coaching.
• Partner with the Manager regarding performance concerns, training opportunities, and professional development needs.

Skills

Coaching & mentoring

Microsoft Office

Care coordination

Data analysis

Education

Bachelor's degree in Nursing or Social Work or related field

Tools

Case Management Certification

Job description

Team Lead, Integrated Care Coordination - Waiver, serves as a working leader responsible for both the day-to-day operational support of assigned Care Coordinators and the direct management of a reduced caseload of MyCare HCBS Waiver members. The Team Lead serves as the first point of escalation for clinical and operational issues and supports achievement of program goals, regulatory requirements, quality standards, and member outcomes.

Provide day-to-day oversight and direction to assigned Care Coordinators.

Monitor daily operational workflows and ensure timely completion of assessments, service plans, contacts, authorizations, and member outreach activities.

Serve as the first level escalation point for staff questions, barriers, member concerns, and operational issues.

Provide consultation regarding HCBS Waiver requirements, service planning, person-centered planning, care coordination, and service delivery.

Assist staff with complex member situations, transition planning, service gaps, provider issues, and member health and welfare concerns.

Support implementation of care plans and service plans in accordance with MyCare HCBS Waiver requirements.

Assist staff with identifying community resources and supports to address member needs.

Support continuity of care activities during transitions between settings, providers, programs, and care coordinators.

Conduct routine documentation audits and quality reviews.

Monitor compliance with assessment, service planning, and outreach timeframes.

Identify trends, risks, and compliance concerns and elevate to the Manager.

Assist in preparation of corrective action activities and quality improvement initiatives.

Monitor adherence to policies, procedures, workflows, regulatory requirements, and operational expectations.

Coach, mentor, and develop assigned Care Coordinators, providing real-time feedback and performance coaching.

Partner with the Manager regarding performance concerns, training opportunities, and professional development needs.

Assist with onboarding and training of new staff and support annual competencies and ongoing staff education initiatives.

Partner with providers, Community Partners, delegates, vendors, and internal departments to support member needs.

Serve as the primary coordinator or consultant for High-risk members, Members with repeated incidents, Complex transition cases, Members requiring multidisciplinary intervention, Members experiencing service gaps or Members with significant social determinants of health challenges

Bachelor's degree in Nursing, Social Work, Human Services, Healthcare Administration or related field preferred

Three (3) years of care management, care coordination, HCBS Waiver, LTSS, Medicaid, or managed care experience required

Knowledge of person-centered service planning principles.

Understanding of Ohio Medicaid, waiver requirements, and managed care operations.

Strong coaching and mentoring skills.

Ability to manage competing priorities in a fast-paced environment.

Ability to analyze performance and quality data.

Proficient in Microsoft Office applications.

Case Management certification preferred

To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.

CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position.

General office environment; Up to 25% (regular) travel may be required to travel to different locations, including homes, offices, or other public settings, to perform work duties

72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Fostering a Collaborative Workplace Culture

Cultivate Partnerships

Pursue Personal Excellence

We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.