Lead Care Coordinator

Reports To: Operations Outreach Supervisor Location: Newark / Hybrid Classification: Exempt OhioRISE | I Am Boundless Summary and Objective The Lead Care Coordinator serves as a bridge across Outreach, Care Coordination, and Clinical Services within the OhioRISE Care Management Entity. The role’s primary focus is monitoring workflows, identifying and addressing gaps between divisions, and providing coaching, mentoring, documentation review, and quality support to staff across these areas. Reporting to the Operations Outreach Supervisor, the Lead collaborates with Care Coordination and Clinical Supervisors, Program Coordinators, Navigators, and training staff to support timely referrals, member engagement, care planning, and continuity of care. The position provides functional guidance without formal supervisory authority. The Lead may maintain a minimal, temporary caseload to address needs arising within any of the three divisions. Assignments may include supporting inpatient referrals, hospital readmissions and transitions, completing initial care plans, and providing short‑term care coordination during assignment or handoff to an ongoing Care Coordinator. Direct service assignments are limited in scope and duration to preserve the position’s primary focus on leading and supporting staff. Essential Functions Leadership and Support Across Divisions Serve as a day-to-day resource for Outreach, Program Coordination, Care Coordination, and Clinical Services staff regarding OhioRISE processes, workflows, timelines, documentation, and community resources. Monitor workflows and member transitions across divisions; identify barriers, coordinate follow-through, and recommend process improvements to the appropriate supervisors. Provide coaching, mentoring, shadowing, and operational support during onboarding and ongoing staff development, including support during newly hired Care Coordinators’ first 90 days in collaboration with training staff and supervisors. Promote consistent OhioRISE standards and High Fidelity Wraparound practices; lead portions of team meetings, huddles, or trainings as assigned. Help resolve operational questions and elevate clinical concerns, compliance issues, and matters requiring supervisory authority to the appropriate leader. Coordinate workload and priorities with the Operations Outreach Supervisor, incorporating input from Care Coordination and Clinical leadership. Outreach Intake and Engagement Monitor referral, outreach, intake, and engagement timelines; support staff in addressing delays and reducing noncompliance that may affect member access and value-based performance. Collaborate with Program Coordinators to review enrollment documents, consents, Releases of Information, and other required intake materials for completeness and timely follow-up. Review preliminary Child and Family-Centered Care Plans for completeness and readiness for assignment and the initial Child and Family Team meeting. Support staff with outreach strategies for difficult-to-engage youth and families and timely follow-up on urgent referrals. Facilitate coordinated handoffs from Outreach or Virtual Care Coordination to ongoing Care Coordination. Hospital Residential and Clinical Collaboration Co-lead operational coordination of inpatient psychiatric, hospital, and Psychiatric Residential Treatment Facility (PRTF) referrals with the Navigator and appropriate Clinical leadership. Support communication among hospitals, residential providers, families, and program staff during admissions, readmissions, inpatient stays, discharge planning, and community reintegration. Monitor transition and discharge timelines, support scheduling of post-discharge Child and Family Team meetings, and help resolve gaps between levels of care. Participate in multidisciplinary meetings as assigned and coordinate operational follow-through with the responsible staff and supervisors. Support staff in implementing Crisis Safety Plans and linking members to crisis and stabilization services, with clinical concerns directed to designated Clinical leadership. Participate in the on-call rotation as assigned. Documentation Quality and Compliance Conduct assigned chart reviews, documentation quality checks, and internal audit preparation activities using SmartCare and other designated systems. Identify documentation trends, missing information, and overdue requirements; provide coaching and coordinate correction follow-up with staff and supervisors. Support adherence to OhioRISE, Ohio Department of Medicaid (ODM), Aetna, and organizational requirements, including documentation timelines. Complete assigned health outcome reporting and data collection activities and communicate findings that inform training and quality improvement. Limited Temporary Direct Care Coordination The following duties apply to assigned members during minimal, temporary coverage and do not establish an ongoing full caseload: Provide short-term outreach, engagement, intake, and care coordination for needs identified through Outreach, Care Coordination, or Clinical Services, including inpatient referrals and hospital transitions. Complete required screenings and assessments, including the Ohio Comprehensive CANS, within the employee’s training, certification, and assigned scope. Develop initial or preliminary Child and Family-Centered Care Plans and Crisis Safety Plans; monitor and update plans during temporary coverage in collaboration with members, families, team members, and licensed professionals as appropriate. Complete required contacts and visits and facilitate Child and Family Team meetings using High Fidelity Wraparound principles when necessary for assigned members. Coordinate referrals and linkages to behavioral health, medical, educational, developmental disability, social service, and natural supports. Complete timely, accurate documentation and a clear handoff to the ongoing Care Coordinator. Community Collaboration and Customer Service Maintain collaborative relationships with hospitals, schools, Children's Services, juvenile courts, Family and Children First Councils, Boards of Developmental Disabilities, behavioral health and primary care providers, managed care organizations, and other community partners. Participate in community meetings and collaborative planning as assigned; identify service gaps and emerging resource needs. Demonstrate professional, responsive, and respectful customer service to youth, families, staff, providers, and stakeholders. Skills Knowledge and Abilities Advanced knowledge of OhioRISE care coordination requirements and working knowledge of High Fidelity Wraparound. Strong coaching, mentoring, facilitation, and meeting coordination skills. Ability to coordinate work across divisions, prioritize competing needs, and manage time so temporary direct services do not displace lead responsibilities. Strong organizational, project management, critical thinking, and problem‑solving skills. Excellent verbal and written communication, professional judgment, diplomacy, and customer service skills. Knowledge of community resources, behavioral health systems, and member transitions between levels of care. Intermediate proficiency in Microsoft Office and electronic health record systems, including SmartCare. Supervisory Responsibility This position has no direct reports. The Lead provides functional guidance, mentoring, workflow monitoring, and quality support across Outreach, Care Coordination, and Clinical Services. Designated supervisors retain authority for hiring, discipline, staff scheduling, and performance evaluations. Education and Experience Required High school diploma or GED. Minimum three years of progressively responsible experience in children’s behavioral health, care coordination, case management, child welfare, juvenile justice, developmental disabilities, or related human services, including at least one year performing OhioRISE Care Coordinator functions or comparable managed-care coordination work. Demonstrated experience in leadership, mentoring, training, or project/workflow coordination. Experience with quality and documentation review and compliance monitoring. Preferred Bachelor’s degree in Social Work, Psychology, Human Services, Sociology, Criminal Justice, Education, or a related field. Experience coaching or mentoring staff and reviewing documentation for quality and completeness. Experience with High Fidelity Wraparound, CANS assessments, or managed care. Experience collaborating with hospitals, inpatient behavioral health providers, schools, courts, and community partners. Additional Eligibility Qualifications Valid Ohio driver’s license, acceptable driving record, and valid automobile insurance. Ability to obtain and maintain required High Fidelity Wraparound and CANS certifications within established timelines. Ability to complete required cultural competency training within established timelines. Ability to obtain and maintain First Aid and CPR certification within organizationally required timelines. #J-18808-Ljbffr I Am Boundless