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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. 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.
Job Responsibility:
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
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
Enhancement of Medical Appropriateness and Quality of Care
Monitoring, Evaluation and Documentation of Care
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
Reliable transportation required
Willing and able to work beyond core business hours of Monday-Friday, 8am-5pm, as needed
Nice to have:
Case management and discharge planning experience
Managed Care experience
Medicaid experience
What we offer:
Affordable medical plan options
401(k) plan (including matching company contributions)
employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
paid time off
flexible work schedules
family leave
dependent care resources
colleague assistance programs
tuition assistance
retiree medical access
Mileage is reimbursed per our company expense reimbursement policy
CVS Health bonus, commission or short-term incentive program