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CVS Health Logo CVS Health · IT - Software Development

Care Management Coordinator OhioRISE- Field - West Region, Ohio

United States, Columbus Employment contract 21.10 - 40.90 USD / Hour · Job Posted May 10, 2026

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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. 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 Ohio to member homes and other requested member locations, up to 50% or more of the time. Applicants may reside within the western region of Ohio. Strongly prefers candidates to reside in one of the following counties: Darke, Defiance, Fulton, Green, Hardin, Henry, Lawrence, Logan, Lucas, Madison, Mercer, Miami, Paulding, Putnam, Scioto, Shelby, Van Wert, Warren, or Williams. Monday-Friday 8-5pm with flexibility needed to work later to meet member needs.

Job Responsibility

  • 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

Requirements

  • 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 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
  • Candidate will reside in Darke, Defiance, Fulton, Green, Hardin, Henry, Lawrence, Logan, Lucas, Madison, Mercer, Miami, Paulding, Putnam, Scioto, Shelby, Van Wert, Warren, or Williams county

Nice to have

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

What we offer

  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Mileage reimbursement
  • Bonus, commission or short-term incentive program
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