Care Management Coordinator OhioRISE - Field - Northeast Region Ohio

CVS Health • Scott Township, OH

21h • $21 - $41 • Hybrid

About The Position

The Care Management Coordinator is a full-time, field-based telework role in Ohio supporting the OhioRISE program. OhioRISE 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 by providing care coordination, support, and education using care management tools and resources.

The role requires travel within the assigned Northeast Ohio region to members’ homes and other member locations, up to 50% or more of the time. The coordinator must reside in Ohio; the posting strongly prefers candidates who live in one of the specified Northeast Ohio counties. The schedule is Monday through Friday, 8 a.m. to 5 p.m., with flexibility to work later as needed to meet member needs. Some travel to the New Albany office may be required for trainings or meetings.

The coordinator evaluates referred members’ needs and eligibility, identifies risk factors and service needs, and recommends appropriate services or referrals. The role coordinates and monitors care plan activities, works with members’ Child and Family Teams and multidisciplinary colleagues, addresses barriers to care, escalates quality-of-care concerns, and supports member engagement and informed healthcare decision-making. Care management and quality management processes must be followed in accordance with regulatory and accreditation guidelines and company policies and procedures.

Requirements

• 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 MS Office Suite 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.
• Bachelor’s degree or non-licensed master-level clinician credential required.
• 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.
• 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.
• Degree in behavioral health, human services, health services, or public health preferred, such as psychology, social work, marriage and family therapy, counseling, or juvenile justice.
• Residence in one of the preferred counties: Cuyahoga, Summit, Medina, Portage, Marion, Wyandot, Crawford, Sandusky, Stark, Belmont, Jefferson, Huron, Harrison, Lake, Geauga, Lorain, or Ashtabula.

Responsibilities

• Demonstrate clinical and cultural competence and responsiveness when managing complex community cases across child-serving systems.
• Evaluate referred members’ needs and eligibility using care management tools and available information; recommend approaches to resolve cases or meet needs.
• Review benefit plans and available internal and external programs and services; identify high-risk factors and service needs that may affect outcomes or care planning.
• 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 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’ benefits or healthcare needs.
• Use influencing and motivational interviewing skills to support member engagement and behavior or lifestyle changes.
• Provide coaching, information, and support to empower members to make independent medical and healthy-lifestyle choices.
• Help members participate knowledgeably with providers in healthcare decision-making.
• Serve as a single point of contact and help members address immediate or 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 members’ homes and other requested locations, and travel to the New Albany office for trainings or meetings as required.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility
• Eligible for a CVS Health bonus, commission, or short-term incentive program in addition to base pay

What This Job Offers

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