CareSource · 23 hours ago
Director, MyCare HCBS Waiver(Preferred Experience with LTSS, Community Based Services, Medicaid, Waivers/Authorizations)
Ohio WFH
Full-time
Hybrid
Mid, Senior Level
$113K/yr - $198K/yr
7+ years expCareSource is a healthcare organization focused on providing comprehensive services, and they are seeking a Director for the MyCare HCBS Waiver program. The role involves overseeing case management programs, ensuring quality care management activities, and managing fiscal and regulatory aspects of the program.
Health CareMedicalNon Profit
Responsibilities
Assures the quality and consistency of MyCare HCBS Waiver care management activities delivered by CareSource staff, delegates, external partners, and contracted vendors
Develops and provides input to align internal policies, procedures, and goals regarding MyCare HCBS Waiver programs
Working with the AVP of Integrated Health, assumes responsibility for the overall function and operational, clinical, and professional growth of MyCare HCBS Waiver services program
Establishes a team culture that drives excellence in member experience, operations, and quality
Supports Health Services programs by contributing to policies, programs, accreditation, cost, and quality activities relative to MyCare HCBS Waiver program
Assumes responsibility for the fiscal and regulatory management of MyCare HCBS Waiver Programs
Assumes a lead role in ensuring high quality case management is delivered within product lines which include MyCare Waiver and LTSS services
Member of the collaborative team and may provide input to the assessments, treatment plans and evaluation of high-risk members in HCBS Waiver settings
Implementation and oversight of all clinical/care management functions for individuals receiving MyCare HCBS Waiver services, including but not limited to: Intake and assessments, care and service planning, care coordination, transition planning, consumer hearings and patient and caregiver education and training
Implementation and oversight of all contracted provider management functions for providers of MyCare HCBS Waiver Services including but not limited to: quality oversight and monitoring and operation of incident management, investigation and response system
Implementation and oversight of all program management functions, including but not limited to compliance with program requirements, rule and regulations
Implementation and management of program policies and procedures and protocols that are aligned with federal and state requirements, for example: member complaints process and community education
Develop, implement, monitor, and/or revise Care Management policies, procedures and goals as needed or required
Ongoing review and revision of MyCare HCBS Waiver Care Management P&P to support compliance, reduce cost, and improve the quality of care
Accountable for the creation and implementation of cost savings initiatives for MyCare Waiver
Manage the care management services for CareSource MyCare HCBS Waiver
Ensure compliance with all contracts, statutes and regulations
Ensure meeting or exceeding appropriate clinical requirements established by State
Ensure that all Care Management programs align with and meet regulatory and accreditation standards
Collaborate with the internal/delegate Care Management staff ongoing and share/implement best practice
Develop, implement, monitor, and/or recommend revisions to government program bids for MyCare HCBS Waiver and LTSS services
Develop and sustain community partner/service agency relationships
Lead pertinent team projects ongoing
Monitor MyCare HCBS Waiver Care Management budgets ongoing; describe variance detail monthly
Participate and represent CareSource externally with speaking engagements, State and regional committee work
Update MyCare HCBS Waiver program description documents annually
Evaluate Care Management effectiveness ongoing and conduct outcome evaluation on all programs ongoing
Coordinate member satisfaction survey activities
Conduct a HCBS MyCare HCBS Waiver program evaluation annually
Create (annually) and monitor (quarterly) the MyCare HCBS Waiver work plan
Perform any other job duties as requested
Qualification
Required
Bachelor's degree in nursing, social work, healthcare administration or related field or equivalent years of relevant work experience is required
Minimum of seven (7) years of experience with government programs including at least 5 years of experience in HCBS waiver programs is required
Three to five (3-5) years of leadership/management experience is required
Current, unrestricted license in the state of Ohio as a Registered Nurse (RN), Licensed Social Worker (LSW) or Licensed Independent Social Worker (LISW), Psychologist, or Licensed Professional Clinical Counselor (LPCC) is required
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position
Employment in this position is conditional pending successful clearance of a driver's license record check
Preferred
Master's degree is preferred
Managed Care experience is preferred
Clinical experience in healthcare delivery is preferred
Facets experience is preferred
Prior experience with and knowledge of CareAdvance is preferred
Case Management certification is highly preferred
Benefits
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.
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