Manager, Rapid Response & Incident Management Operations

Job Summary:

The Manager, Rapid Response & Incident Management Operations provides leadership and direction to the Rapid Response Team and Incident Management Team to ensure the goals and standards of the department and CareSource are met. This role is responsible for overseeing centralized escalation and incident management processes to ensure timely, compliant, and high-quality resolution of member, provider, regulatory, and operational issues.

Essential Functions:

• Responsible for overseeing escalation and incident management processes and understanding the impact of issues across various departments within the organization.
• Responsible for quality of outputs and operational efficiency of the Rapid Response and Incident Management teams.
• Responsible for managing staff to ensure timely, accurate, and high-quality completion of escalations and incident resolution activities.
• Oversee intake, triage, and resolution of escalations including member, provider, regulatory, and executive-level concerns.
• Ensure accurate and timely tracking and monitoring of critical incidents in accordance with regulatory and organizational requirements.
• Responsible for complying with and meeting all regulatory requirements assigned to their team, including incident reporting and escalation response timelines.
• Manage escalation and incident management systems, trackers, and associated workflows (e.g., SharePoint, ServiceNow, RDM, and internal systems).
• Manage all regulatory and internal escalation responses to ensure accurate and timely submission; develop and implement corrective action plans as needed.
• Gather, analyze, and report data related to escalation and incident performance; make recommendations for process improvements.
• Actively participate in ongoing development of new processes, tools, and technologies to support centralized operations.
• Manage daily operations and projects through effective allocation of resources.
• Incorporate effective change management and risk mitigation strategies within escalation and incident workflows.
• Develop and maintain an in-depth knowledge of the company's business, care coordination workflows, and regulatory environments.
• Mentor team members to produce consistent, high-quality deliverables and support a "one-call resolution" approach when possible.
• Responsible for hiring, training, coaching, and developing direct reports, including completing performance appraisals and disciplinary actions.
• Perform any other job related duties as requested.

Education and Experience:

• Bachelor's degree in project management, Business, Computer Science or related field required
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Three (3) years of leadership/management experience required
• Three (3) years of experience in healthcare operations, care coordination, escalation management, or call center operations required required
• Experience working in project management software and managing projects of up to $10M+ in budget required
• Experience in the healthcare payer industry required

Competencies, Knowledge and Skills:

• Excellent proficiency with Microsoft Office tools, including Project, Word, PowerPoint, Excel, Visio, Teams, Outlook, etc.
• Demonstrates excellent analysis and reporting skills
• Excellent decision making/problem solving skills
• Exceptional interpersonal and relationship building skills
• Excellent critical listening and thinking skills
• Proven ability to effectively interact with all levels of the organization of management within and externally to the organization
• Excellent written and verbal communication skills
• Customer service oriented
• Ability to shape the approach to needed results and gain consensus of the approach
• Ability to proactively, effectively and efficiently lead a project team of 20+ core members and multiple vendors
• Strong knowledge of regulatory reporting and audit readiness processes
• Proven ability to prioritize work and team assignments to deliver projects on time, on budget, and meeting stakeholders expectations
• Demonstrates a sense of urgency
• Deep understanding of project management processes, techniques and tools, and development lifecycle (ideally Agile)
• Strong understanding of healthcare operations, care coordination, and escalation management processes
• Knowledge of Medicaid, Medicare, and Dual programs, including regulatory and compliance requirements
• Knowledge of HIPAA, data exchange processes, and operational compliance standards

Licensure and Certification:

• None required

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Up to 25% (regular) travel based on the needs of the department may be required

Compensation Range:
$83,000.00 - $132,800.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, 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.

Compensation Type:
Salary

Competencies:
- Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-RW1