Manager, Rapid Response & Incident Management Operations

• 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.

• 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

• 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

• None required

• 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:

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 (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business