Field-Based Care Manager, Ohio Health Coordination

CVS Health Corporation

Marion (OH)

Remote

USD 44,000 - 85,000

Full time

3 days ago

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Job summary

CVS Health is seeking a Case Management Coordinator for the Northeast/Northwest Ohio region. This full-time field-based telework role requires travel to member homes and other locations up to 50% of the time.

You will evaluate member needs, coordinate care plans, and collaborate with multidisciplinary teams to ensure high-quality care. The ideal candidate has a Bachelor’s degree or a non-licensed master’s in behavioral health or related field, 2+ years in behavioral health, and experience with

Qualifications

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 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
Willing and able to work beyond core business hours of Monday-Friday, 8am-5pm, as needed.

Responsibilities

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.
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 provi
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.