Care Management Coordinator OhioRISE - Field - Central/SE Ohio

CVS Health • Chillicothe, OH

2d • Hybrid

About The Position

The Care Management Coordinator supports the OhioRISE program, which provides comprehensive, coordinated behavioral health services for 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 collaborate in the case management process and facilitate appropriate healthcare outcomes through care coordination, support, and education using care management tools and resources.

This is a full-time, field-based telework position in Ohio. The coordinator must reside in Ohio and be able to travel within the assigned Central and Southeast Ohio region to members’ homes and other requested locations, up to 50% or more of the time. Some travel to the New Albany office may be required for training or meetings. The schedule is Monday through Friday, 8 a.m. to 5 p.m., with flexibility to work later as needed to meet member needs. Reliable transportation is required; mileage is reimbursed under the company expense reimbursement policy.

The role requires a bachelor’s degree or a non-licensed master-level clinician. Degrees in behavioral health, human services, health services, or public health are preferred. The position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the stated base pay range.

Requirements

• Bachelor’s degree or non-licensed master-level clinician required.
• At least 2 years of experience in behavioral health, social services, or human services.
• At least 2 years of experience with 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 a public-sector human services or behavioral health care field, 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 and be willing and able to travel within the assigned region up to 50% of the time.
• Reliable transportation 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; examples include psychology, social work, marriage and family therapy, counseling, and juvenile justice.
• Residence in one of the listed preferred counties: Fairfield, Franklin, Licking, Muskingum, Perry, Pickaway, Hocking, Fayette, Ross, Richland, or Highland.

Responsibilities

• Conduct comprehensive evaluations of referred members’ needs and eligibility using care management tools and information or data review.
• Recommend approaches to resolving cases and meeting member needs by evaluating benefit plans and available internal and external programs and services.
• Identify high-risk factors and service needs that may affect outcomes and care planning, and make appropriate referrals to clinical case management or crisis intervention.
• 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 to goals and objectives.
• Present cases at case conferences for multidisciplinary review and collaborate with members’ Child and Family Teams.
• Identify and escalate quality-of-care issues through established channels.
• Use negotiation skills 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 empower members to make independent medical and healthy lifestyle choices.
• Help members participate actively and knowledgeably in healthcare decisions with their 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 member locations, and attend trainings or meetings at the New Albany office as needed.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources supporting colleagues’ and families’ physical, emotional, and financial well-being, based on eligibility
• Mileage reimbursement under the company expense reimbursement policy
• Eligibility for a CVS Health bonus, commission, or short-term incentive program

What This Job Offers

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