Team Lead, Integrated Care Coordination - Waiver--Must live in Ohio
About The Position
The Team Lead, Integrated Care Coordination - Waiver is a working leader who provides day-to-day operational support and direction to assigned Care Coordinators while managing a reduced caseload of MyCare HCBS Waiver members. The role serves as the first point of escalation for clinical and operational issues and supports program goals, regulatory compliance, quality standards, and member outcomes. The position must be based in Ohio. The Team Lead supports workflows, staff development, quality reviews, service planning, and care coordination. The role also works with providers, community partners, delegates, vendors, internal departments, and other stakeholders to address member needs and maintain continuity of care. The position requires an associate degree in healthcare and at least three years of relevant experience in care management, care coordination, HCBS Waiver, LTSS, Medicaid, or managed care. A current, unrestricted RN or LSW license in the state of practice is required. A valid driver's license, vehicle, and verifiable insurance are also required. Annual influenza vaccination is required for designated positions during influenza season. The role is based in a general office environment, may involve extended sitting or standing, and may require up to 25% regular travel to homes, offices, or other public settings.
Requirements
- Associate degree in healthcare.
- At least three years of care management, care coordination, HCBS Waiver, LTSS, Medicaid, or managed care experience.
- Current, unrestricted Registered Nurse (RN) license or current, unrestricted Licensed Social Worker (LSW) license in the state of practice.
- Valid driver's license, vehicle, and verifiable insurance; employment is conditional on an acceptable driver's license record check.
- Annual proof of influenza vaccination is required for designated positions during influenza season (October 1–March 31); employees hired during that period have 30 days from hire to complete the vaccination and verify immunization.
- Strong knowledge of MyCare HCBS Waiver and LTSS programs.
- Knowledge of person-centered service planning principles.
- Understanding of Ohio Medicaid, waiver requirements, and managed care operations.
- Strong coaching and mentoring skills.
- Strong organizational and problem-solving abilities.
- Ability to manage competing priorities in a fast-paced environment.
- Strong written and verbal communication skills.
- Ability to analyze performance and quality data.
- Proficiency in Microsoft Office applications.
Nice To Haves
- Bachelor's degree in Nursing, Social Work, Human Services, Healthcare Administration, or a related field.
- Prior leadership experience.
- Case Management certification.
Responsibilities
- Provide day-to-day oversight and direction to assigned Care Coordinators.
- Monitor daily workflows and ensure timely completion of assessments, service plans, contacts, authorizations, and member outreach.
- Serve as the first 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.
- Consult on HCBS Waiver requirements, service planning, person-centered planning, care coordination, and service delivery.
- Help staff address 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.
- Help staff identify community resources and supports for members.
- Support continuity of care 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 them to the Manager.
- Assist with 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, including providing real-time feedback and performance coaching.
- Partner with the Manager on performance concerns, training opportunities, and professional development needs.
- Assist with onboarding and training new staff and support annual competencies and ongoing staff education.
- 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 on HCBS Waiver program requirements and operational processes.
- Maintain a reduced caseload as assigned.
- Serve as primary coordinator or consultant for high-risk members, members with repeated incidents, complex transition cases, members requiring multidisciplinary intervention, members experiencing service gaps, and members with significant social determinants of health challenges.
- Perform other job-related duties as requested.
Benefits
- May qualify for a bonus tied to company and individual performance.
- Comprehensive total rewards package.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
