Lead Program Coordinator

Care Management Entity | OhioRISE

Classification: Exempt

Reports to: Operations Outreach Supervisor

Location: Newark / Hybrid

Summary / Objective

The Lead Program Coordinator is a working-lead role that provides day-to-day functional leadership for the OhioRISE Program Coordinator team. The Lead coordinates outreach and intake workflows, supports onboarding and mentoring, reviews documentation, monitors compliance, and identifies process improvements. The position works with the Operations Outreach Supervisor and internal partners to promote timely referrals, consistent enrollment and waiver processes, and continuity of member services while maintaining a reduced Program Coordinator workload.

Workload and Functional Authority

The Operations Outreach Supervisor will establish and periodically review a reduced Program Coordinator workload to allow dedicated time for lead, quality review, and training responsibilities. Individual productivity expectations will reflect this balance.

• Coordinate daily workflow, priorities, coverage, and workload distribution within the direction and authority delegated by the Operations Outreach Supervisor.
• Review Program Coordinator work for completeness, accuracy, and timeliness; provide coaching, coordinate corrections, and track follow-up.
• Escalate performance concerns, unresolved compliance issues, and operational barriers to the Operations Outreach Supervisor for decisions and formal follow-up.
• This position has no direct reports and no authority for hiring, firing, discipline, formal performance evaluations, or other HR supervisory decisions.

Essential Functions

Leadership and Team Support

• Serve as the primary day-to-day resource for OhioRISE referral, enrollment, waiver, transition, and workflow questions.
• Support onboarding, orientation, mentoring, and cross-training of Program Coordinators; identify training needs and share consistent practices.
• Monitor referral timeliness, case progression, workload balance, and coverage needs; coordinate workflow adjustments with the Operations Outreach Supervisor.
• Identify barriers affecting productivity or compliance, recommend process improvements, and assist with operational projects and reporting.
• Serve as a liaison between Program Coordinators and the Operations Outreach Supervisor; provide delegated workflow and referral support during supervisor absences.

Quality and Compliance

• Conduct routine quality reviews of referrals, enrollments, waiver documentation, transfers, transitions, and disenrollments.
• Monitor compliance with OhioRISE contractual timelines and documentation requirements; coach staff on corrections and track completion.
• Identify documentation trends, process gaps, and recurring issues; support quality improvement, audit preparation, and corrective action follow-up.
• Collaborate with the Lead Health Data Specialist and Care Coordination leadership to resolve referral, enrollment, and documentation issues.

Program Coordination

Perform Program Coordinator duties within the reduced workload established by the Operations Outreach Supervisor, including:

• Receive and coordinate referrals for Intensive and Moderate Care Coordination; conduct outreach to youth and families, explain OhioRISE services, and obtain required consents.
• Monitor engagement efforts, communicate with the OhioRISE Plan regarding unsuccessful outreach, and coordinate referral routing through transition to the assigned Care Coordinator.
• Process enrollments, transfers, disenrollments, and transitions, including youth entering or exiting the OhioRISE Waiver.
• Complete assigned waiver activities, including Level of Care assessments, CANS, prior authorizations, annual redeterminations, and flexible fund coordination, within applicable certification and program requirements.
• Meet documentation, quality, contractual, and adjusted productivity expectations; provide professional, culturally responsive service to families, providers, community partners, and internal departments.
• Perform other duties as assigned.

Skills, Knowledge, and Abilities

• Advanced working knowledge of OhioRISE referral, enrollment, waiver, and transition processes.
• Strong leadership, mentoring, communication, and peer-coaching skills.
• Ability to prioritize competing needs, coordinate workflows, review documentation, and identify process improvements.
• Strong organization, time management, critical thinking, problem-solving, and conflict-resolution skills.
• Ability to work independently, support team collaboration, and recognize when concerns require escalation.

Education and Experience

Required

• High school diploma or GED.
• Minimum of three years of experience in children’s behavioral health, care coordination, child welfare, developmental disabilities, juvenile justice, or related human services.
• Minimum one year of experience performing OhioRISE referral, enrollment, transition, and waiver functions, or equivalent experience with comparable care-management processes.
• 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, or a related field.

Additional Eligibility Requirements

• Valid Ohio driver’s license, acceptable driving record, and valid automobile insurance.
• Current CANS certification or ability to obtain certification within 90 days; maintain certification as required.
• Complete required cultural competency training within established timelines and demonstrate culturally responsive practices when working with youth, families, staff, and community partners.