Care Management Coordinator OhioRISE - Field - Central/SE Ohio

CVS Health • Mentor, KY

8d • $21 - $41 • Hybrid

About The Position

The Care Management Coordinator supports the OhioRISE program, which provides comprehensive, highly coordinated behavioral health services to children with serious or complex behavioral health needs who are involved in, or at risk of involvement in, multiple child-serving systems. The coordinator uses critical thinking and judgment to facilitate appropriate healthcare outcomes by providing care coordination, support, and education using care management tools and resources. The role requires clinical and cultural competence and the ability to manage complex community-based cases across child-serving systems.

This is a full-time, field-based telework position for someone residing in Ohio, serving the Central and Southeast Ohio region. The role requires travel to members’ homes and other locations in the assigned region up to 50% or more of the time; some travel to the New Albany office may be required for training or meetings. The usual schedule is Monday through Friday, 8 a.m. to 5 p.m., with flexibility to work later as member needs require. Reliable transportation is required, and mileage is reimbursed under the company expense policy.

Requirements

• Bachelor’s degree or a non-licensed master-level clinician qualification is required.
• At least 2 years of experience in behavioral health, social services, or human services.
• At least 2 years of experience using personal computers, keyboarding, multi-system navigation, and Microsoft Office applications, including Outlook, Word, Excel, and SharePoint.
• At least 2 years of experience in children’s mental health, child welfare, developmental disabilities, juvenile justice, or public-sector human services or behavioral healthcare, providing community-based services to children and youth and their families or caregivers.
• At least 2 years of experience in one or more of the following: family systems, community systems and resources, case management, child and family counseling or therapy, child protection, or child development.
• At least 2 years of experience with Ohio delivery systems, including local community networks and resources.
• Must reside in Ohio.
• Must be willing and able to travel within the assigned region up to 50% of the time; some travel to the New Albany office may be required for training or meetings.
• Reliable transportation is required.
• Must be willing and able to work beyond Monday–Friday, 8 a.m.–5 p.m. core business hours as needed.

Nice To Haves

• Case management and discharge planning experience.
• Managed care experience.
• Medicaid experience.
• A degree in behavioral health, human services, health services, or public health is preferred; examples include psychology, social work, marriage and family therapy, counseling, and juvenile justice.

Responsibilities

• Assess referred members’ needs and eligibility using care management tools, information, and data; recommend approaches to resolve cases or meet needs based on benefit plans and available programs and services.
• Identify high-risk factors and service needs that may affect member outcomes and care planning, and refer members to clinical case management or crisis intervention when appropriate.
• Coordinate and implement assigned care plan activities and monitor progress.
• Consult with case managers, supervisors, Medical Directors, and other health or behavioral health programs to address barriers and achieve care goals.
• Present cases at case conferences for multidisciplinary review.
• Collaborate with members’ Child and Family Teams.
• Identify and escalate quality-of-care issues through established channels.
• Negotiate to secure appropriate options and services that meet members’ benefit and healthcare needs.
• Use influencing and motivational interviewing skills to engage members and promote lifestyle or behavior changes.
• Provide coaching, information, and support to help members make independent medical and healthy-lifestyle choices and participate knowledgeably in healthcare decisions with providers.
• Serve as a single point of contact for members and help address immediate and acute gaps in care and access.
• Use case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
• Travel within the assigned region to member homes and other requested locations, and attend trainings or meetings at the New Albany office when required.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources to support colleagues’ physical, emotional, and financial well-being, based on eligibility
• Eligibility for a CVS Health bonus, commission, or short-term incentive program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level