Case Management Coordinator OhioRISE - Field - Northeast/Northwest Ohio

CVS Health•Fremont, OH

5d•$21 - $41•Remote

About The Position

The Case Management Coordinator supports the OhioRISE program, which provides comprehensive, 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 role uses critical thinking and judgment to collaborate on case management and facilitate appropriate healthcare outcomes through care coordination, support, and member education using care management tools and resources. This is a full-time, field-based telework position for someone who resides in Ohio and can travel within the assigned Northeast Ohio region to members’ homes and other locations, up to 50% or more of the time. The schedule is Monday through Friday, 8 a.m. to 5 p.m., with flexibility to work later when needed to meet member needs. Travel to the New Albany office may be required for training or meetings; reliable transportation is required, and mileage is reimbursed under company policy.

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 using personal computers, keyboarding, multiple-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 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.
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 required.
Must be willing and able to work beyond Monday–Friday, 8 a.m.–5 p.m. core business hours as needed.
Must be able to reside in one of the listed counties: Marion, Crawford, Sandusky, Summit, Medina, Lorain, Portage, Geauga, Lake, Ashtabula, Stark, Belmont, Tuscarawas, or Harrison.

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.
Preference for candidates residing in Marion, Crawford, Sandusky, Summit, Medina, Lorain, Portage, Geauga, Lake, Ashtabula, Stark, Belmont, Tuscarawas, or Harrison County.

Responsibilities

Demonstrate clinical and cultural competence and responsiveness when managing complex community-based cases across child-serving systems.
Evaluate referred members’ needs and eligibility using care management tools and information review; recommend approaches to resolve cases or meet needs by assessing benefit plans and available internal and external services.
Identify high-risk factors and service needs that may affect member 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 and achieve care goals.
Present cases at multidisciplinary case conferences to support optimal outcomes.
Work collaboratively 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 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.
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.
Document and monitor care using case management and quality management processes in accordance with regulatory and accreditation guidelines and company policies and procedures.