Case Management Coordinator OhioRISE- Field - West Region

CVS Health Corporation; Columbus (OH); Hybrid; USD 29,000 - 56,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation seeks a Case Management Coordinator in Ohio's West Region. This full-time field-based telework role requires travel to member homes and locations, up to 50% of the time, with a schedule Monday–Friday 8–5 and flexibility for extended hours to meet member needs.

You will evaluate member needs, coordinate care plans, and collaborate with multidisciplinary teams to ensure quality outcomes.

Qualifications

• 2+ years of experience in behavioral health, social services, or human services.
• 2+ years of experience with MS Office Suite (Outlook, Word, Excel, SharePoint).
• 2+ years of experience in children's mental health or public sector human services.
• Must reside in the West Region of Ohio and be willing to travel up to 50%.

Responsibilities

• Collaborate to coordinate care and support for members across systems.
• Evaluate members' needs and monitor progress with care plans.
• Coordinate and implement care plan activities and referrals.
• Engage with Child and Family Teams to improve outcomes.
• Document care processes in compliance with guidelines.

Skills

Case management

Behavioral health

MS Office

Communication skills

Travel readiness

Education

Bachelor's or Master's in behavioral health or related field

Tools

MS Office Suite

SharePoint

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Must reside in West Region Ohio Counties

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

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.

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.
• Must reside in the West Region of Ohio; Counties include
• Hamilton, Clermont, Brown, Clinton, Butler, Preble, Darke, Miami, Warren, Montgomery, Champaign, Greene, Lucas, Hardin, Henry, Putnam, Lawrence, Scioto, Adams, Seneca, Fulton, Williams, Defiance, Henry, Paulding, Putnam, Van Wert, Allen, Mercer, and Auglaize.
• 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 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

The typical pay range for this role is:

$21.10 - $40.90

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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.