CareSource · 12 hours ago
TL, Integrated Care-Post Acute - UM and Waiver Experience
United States
Full-time
Remote
Mid, Senior Level
$72K/yr - $116K/yr
5+ years expCareSource is a healthcare organization dedicated to providing quality care and services. The Team Lead, Integrated Care - Post Acute is responsible for overseeing Post-Acute Clinical employees and managing day-to-day operations to ensure quality and productivity standards are met.
Health CareMedicalNon Profit
Responsibilities
Provide direct oversight of post-acute department staff and oversee day-to-day workflow within the team
Ensure all direct reports are performing at minimum quality and productivity standards or better
Understand complexities of health conditions and services including HCBS enrollment and disenrollment processes, NF level of care, and market NF disenrollment processes
Develop plan for management of workload after analyzing trends and act as advocate for the team
Provide feedback, guidance, orientation, training and ongoing resources to team
Standardize activity and outcome reporting for department initiatives and programs including documentation required by the State and accrediting bodies
Responsible for utilization review, level of care review, HCBS waiver enrollment and disenrollment, and discharge planning activities for CareSource members
Monitor and ensure appropriate delivery of healthcare services in cost-effective manner
Assist manager and director in development of process improvement activities and refining of processes that facilitate cost-effective utilization and appropriate levels of care
Support and facilitate collaboration with Care Management, Claims, Enrollment, Customer Service and other areas as needed to assist in problem resolutions
Perform audits of team members to ensure compliance with CareSource policies, processes, regulatory requirements, NCQA utilization review guidelines and standards, and URAC review guidelines
Provide input into direct report employee evaluations and assist with development of team goals
Assist in the development of procedures, processes, and/or workflows to address regulatory and contractual requirements
Provide education to team to ensure compliance with policies and procedures
Design and present post-acute informational meetings as needed
Responsible for attending state hearings as necessary
Perform any other job duties as requested
Qualification
Required
Nursing degree from an accredited nursing program is required
One year of Utilization Management/Utilization Review experience required
Current, unrestricted licensure in state of practice as a Registered Nurse (RN) is required
Preferred
Bachelor of Science degree in Nursing or equivalent years of relevant work experience is preferred
Minimum of five (5) years clinical experience preferred
Managed care experience is preferred
Certified Care Manager experience is preferred
Multi-state licensure is preferred
MCG certification is preferred
Benefits
You may qualify for a bonus tied to company and individual performance.
Substantial and comprehensive total rewards package.
Company
CareSource
CareSource provides managed care services to Medicaid beneficiaries.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
FHLB Cincinnati
2026-01-17Grant
Leadership Team
Erhardt Preitauer
President & Chief Executive Officer
Jason Bearden
Market President and CEO, Georgia
Recent News
2026-01-18
Dayton Daily News
2025-12-17
Company data provided by crunchbase