Care Management Coordinator (North East Region) OhioRISE

CVS Pharmacy; Columbus (OH); Remote; USD 29,000 - 56,000; Full time

Benefits offered by this job

Mileage reimbursement

Medical benefits

Paid time off

Job summary

CVS Health is seeking a Case Management Coordinator to provide field-based care coordination in Northeast Ohio. The role involves evaluating members, planning care, and collaborating with health teams, with travel up to 50% and occasional office trainings in Columbus area.

The position requires a 2+ year background in behavioral health or related fields, plus strong MS Office skills and the ability to work extended hours when needed to meet member needs.

Qualifications

• 2+ years of experience in behavioral health, social services, or human services.
• 2+ years of experience with MS Office Suite applications (Outlook, Word, Excel, SharePoint).
• Willing and able to travel within the assigned region up to 50% of the time; Ohio delivery systems knowledge preferred.

Responsibilities

• Perform comprehensive evaluation of referred members, assess needs and benefits, and propose case resolution strategies.
• Coordinate and monitor care plans, ensuring progress and alignment with member goals.
• Collaborate with case managers, supervisors, and health teams to optimize care quality and engagement.
• Maintain documentation in line with regulatory and accreditation requirements.

Skills

Behavioral health

Field travel

Communications

MS Office

Education

Bachelor's degree in behavioral health or related field

Tools

MS Office Suite

SharePoint

Job description

Available in 21 locations

Position Summary

This is a full-time field-based telework position, in Ohio. This position requires the ability to travel within the assigned region of Northeast Ohio to member homes and other requested member locations, up to 50% or more of the time.

Applicants may reside within the Northeast region of Ohio. Strongly prefers candidates to reside in one of the following counties: Cuyahoga, Lorain, Medina, Summit, Lake, Geauga.

Monday-Friday 8-5pm with flexibility needed to work later to meet member needs.

Business Overview

As part of the bold vision to deliver the Next Generation of managed care in Ohio Medicaid, OhioRISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed 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 utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Must reside in Ohio.

Fundamental Components

• Be clinically and culturally competent/responsive with training and experience necessary to manage complex cases in the community across child-serving systems.
• Evaluation of Members:
  • Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Identifies 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 as appropriate.
  • Coordinates and implements assigned care plan activities and monitors care plan progress.
• Enhancement of Medical Appropriateness and Quality of Care:
  • Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health/behavioral health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
  • Works collaboratively with the members' Child and Family Teams.
  • Identifies and escalates quality of care issues through established channels.
  • Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
  • Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
  • Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
  • Helps member actively and knowledgably participate with their provider in healthcare decision-making.
  • Serves a single point of contact for members and assist members to remediate immediate and acute gaps in care and access.
• Monitoring, Evaluation and Documentation of Care:
  • Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Pay Range

The typical pay range for this role is:

Minimum: 21.10

Maximum: 36.78

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above.

Required Qualifications

• 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.

Preferred Qualifications

• Case management and discharge planning experience.
• Managed Care experience.
• Medicaid experience.

Education

Bachelor’s degree or non-licensed master level clinician required, with either degree being in behavioral health, human services, health services, or public health preferred. (i.e. psychology, social work, marriage and family therapy, counseling, juvenile justice).

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

$21.10 - $40.90

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time, and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit

jobs.CVSHealth.com/benefits

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

If you are a CVS Health colleague, please log into Workday through ColleagueZone.

CVS Health® and its businesses lead the way to drive affordability, improve access and preserve choice in how people pay for care, receive care and stay healthy. With a wide range of career areas, you can be a part of our purpose-driven team.

Our workforce is dedicated and talented – more than 300,000 colleagues strong – focused on a bold vision to reimagine health care and our passion to make a difference. We unite around making health and care better for colleagues by striving to provide innovative and inclusive benefits for colleagues and their families.

We reflect the consumers we serve and recognize that having diverse teams fosters a workplace where every colleague feels welcomed, valued, respected and heard. There is a place of opportunity for all here and for everyone to be extraordinary.