Case Management Coordinator OhioRISE - Field - Northeast/Northwest Ohio

CVS Health • Streetsboro, OH

4d • Hybrid

About The Position

The Case 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 support case management and facilitate appropriate healthcare outcomes through care coordination, education, and the use of care management tools and resources.

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

Requirements

• Bachelor’s degree or non-licensed master-level clinician.
• 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 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 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.
• Must 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 hours as needed.

Nice To Haves

• Case management and discharge planning experience.
• Managed care experience.
• Medicaid experience.
• Residence in Marion, Crawford, Summit, Medina, Lorain, Portage, Geauga, Ashtabula, Stark, Belmont, Tuscarawas, or Harrison County.
• A degree in behavioral health, human services, health services, or public health, such as psychology, social work, marriage and family therapy, counseling, or juvenile justice.

Responsibilities

• Use care management tools and information review to evaluate referred members’ needs and eligibility, identify high-risk factors and service needs, and recommend approaches to address them.
• Evaluate members’ benefit plans and available internal and external programs and services; 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 and 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.
• Use negotiation skills to secure appropriate services and options that meet members’ benefit and healthcare needs.
• Use influencing and motivational interviewing skills to encourage member engagement and support healthy behavior changes.
• Coach and support members, empowering them to make independent medical and healthy lifestyle choices and participate knowledgeably in healthcare decisions.
• Serve as a single point of contact for members and help address immediate and acute gaps in care and access.
• Document and monitor care using case management and quality management processes in accordance with regulatory, accreditation, and company requirements.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, 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