Care Management Coordinator

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Perform thorough assessments of the needs and eligibility of referred members.

• Suggest strategies for case resolution and fulfilling member requirements.

• Assess benefit plans alongside internal and external programs/services.

• Recognize high-risk factors and service necessities, making suitable referrals.

• Coordinate and execute designated care plan activities while monitoring progress.

• Consult with case managers, supervisors, Medical Directors, and health/behavioral health programs to address barriers.

• Present cases during case conferences for multidisciplinary evaluation.

• Collaborate with members’ Child and Family Teams.

• Identify and escalate issues pertaining to quality of care.

• Negotiate suitable options and services to address member benefits and healthcare requirements.

• Utilize motivational interviewing techniques to enhance member engagement and encourage behavior change.

• Offer coaching, information, and support for independent medical and healthy lifestyle choices.

• Assist members in making informed healthcare decisions with providers.

• Act as a single point of contact to resolve immediate care gaps and access issues.

• Implement case management and quality management processes in accordance with regulatory, accreditation, and company standards.

• Travel to member residences and other specified locations within Western Ohio.

⛳️ Requirements

• Minimum of 2 years of experience in behavioral health, social services, or human services.

• At least 2 years of experience using personal computers, keyboarding and navigating multiple systems, and MS Office Suite applications (Outlook, Word, Excel, SharePoint).

• A minimum of 2 years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or public sector human services or behavioral health care, delivering community-based services to children, youth, and their family/caregivers.

• At least 2 years of experience with family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development.

• Minimum of 2 years of experience with Ohio delivery systems, including local community networks and resources.

• Candidates must reside in the West Region of Ohio; eligible counties include Butler, Hamilton, Clermont, Warren, Montgomery, Allen, Hardin, Defiance, or Lucas.

• Must be willing and able to travel within the assigned region up to 50% of the time.

• Occasional travel to the New Albany office may be necessary for training and meetings.

• Reliable transportation is required.

• Willingness and ability to work beyond standard business hours as needed.

• A Bachelor's degree or a master's level clinician qualification is required in behavioral health, human services, health services, or public health.

• Experience in case management and discharge planning is preferred.

• Managed Care experience is preferred.

• Medicaid experience is preferred.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting colleagues’ physical, emotional, and financial well-being.

• Mileage reimbursement according to company expense reimbursement policy.