Team Lead, Integrated Care Coordination - Waiver

CareSource • Mobile, AL

1d • $72,200 - $115,500 • Hybrid

About The Position

The 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 acts as the first point of escalation for clinical and operational issues and supports the achievement of program goals, regulatory requirements, quality standards, and member outcomes.

Requirements

• Associates degree in healthcare required
• Three (3) years of care management, care coordination, HCBS Waiver, LTSS, Medicaid, or managed care experience required
• Current, unrestricted Registered Nurse (RN) license in state of practice or current, unrestricted Licensed Social Worker (LSW) in state of practice is required
• Must have valid driver's license, vehicle and verifiable insurance.
• Influenza vaccination is a requirement of this position.

Nice To Haves

• Bachelor's degree in Nursing, Social Work, Human Services, Healthcare Administration or related field preferred
• Prior leadership experience is preferred
• Case Management certification preferred

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.
• Facilitate team huddles, case reviews, and workload discussions.
• Assist with caseload balancing and workload distribution.
• 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 escalate 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.
• Participate in interdisciplinary meetings, operational workgroups, and stakeholder meetings as assigned.
• Serve as a resource regarding HCBS Waiver program requirements and operational processes.
• Maintain a reduced caseload as assigned.
• 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.
• Perform any other job related duties as requested.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree