Case Management Coordinator - Field - OhioRISE Northeast/Northwest Ohio

CVS Health•Mentor, KY

3d•Remote

About The Position

This is a full-time field-based telework position in Ohio, requiring travel within the assigned region of Northeast Ohio to member homes and other requested member locations up to 50% or more of the time. The OhioRISE Program aims to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems. The Case Management Coordinator uses critical thinking and judgment to collaborate and inform the case management process, facilitating appropriate healthcare outcomes for members through care coordination, support, and education.

Requirements

Bachelor’s degree or non-licensed master level clinician required
2+ years of experience in behavioral health, social services, or human services
2+ years of experience with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint).
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 family/caregivers.
2+ years experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development.
2+ year of experience with Ohio delivery systems, including local community networks and resources.
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 trainings/meetings
Reliable transportation required
Mileage is reimbursed per our company expense reimbursement policy
Willing and able to work beyond core business hours of Monday-Friday, 8am-5pm, as needed.
Must reside in Ohio.

Nice To Haves

Case management and discharge planning experience.
Managed Care experience.
Medicaid experience.
Reside in Marion, Crawford, Sandusky, Summit, Cuyahoga, Portage, Geauga, Lake, Ashtabula, Stark, or Belmont County.

Responsibilities

Conduct comprehensive evaluation of referred member's needs/eligibility using care management tools and information/data review.
Recommend an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
Identify high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention.
Coordinate and implement assigned care plan activities and monitor care plan progress.
Consult with case managers, supervisors, Medical Directors and/or other health/behavioral health programs to overcome barriers to meeting goals and objectives.
Present cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes.
Work collaboratively with the members' Child and Family Teams.
Identify and escalate quality of care issues through established channels.
Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
Provide coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Help member actively and knowledgeably participate with their provider in healthcare decision-making.
Serve as a single point of contact for members and assist members to remediate immediate and acute gaps in care and access.
Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.