Case Management Coordinator - Field - OhioRISE Northeast/Northwest Ohio

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

Full‑time field‑based telework position in Ohio. Requires travel within the assigned Northeast Ohio region to member homes and other requested locations up to 50% or more of the time. Applicants may reside within the Northeast care coordination region of Ohio; strongly preferred counties: Marion, Crawford, Sandusky, Summit, Cuyahoga, Portage, Geauga, Lake, Ashtabula, Stark, Tuscarawas, or Belmont. Work schedule is Monday‑Friday 8 am‑5 pm with flexibility to work later to meet member needs.

Business Overview

The OhioRISE program delivers “Next Generation” managed care for Ohio Medicaid, helping children with serious or complex behavioral health needs and their families through coordinated services across child‑serving systems. The Case Management Coordinator collaborates with MCOs, vendors, and ODM to provide comprehensive, highly coordinated behavioral health services.

Responsibilities

• Conduct comprehensive evaluations of referred members using care‑management tools and data review; determine eligibility, recommend case‑resolution approaches, and identify high‑risk factors.
• Coordinate and implement assigned care‑plan activities, monitor progress, and collaborate with case managers, supervisors, Medical Directors, and multidisciplinary teams to overcome barriers and achieve optimal outcomes.
• Serve as a single point of contact for members, providing coaching, information, and support to empower independent medical and lifestyle decisions; use motivational interviewing and negotiation skills to secure appropriate services.
• Present cases at conferences, identify and escalate quality‑of‑care issues, and ensure compliance with regulatory, accreditation, and company policies.
• Document care activities using case‑management and quality‑management processes.
• Travel within the assigned region up to 50% of the time; occasional travel to the New Albany office for trainings/meetings; reliable transportation required (mileage reimbursed).

Required Qualifications

• Bachelor’s degree or non‑licensed master‑level clinician credential.
• 2+ years experience in behavioral health, social services, or human services.
• 2+ years experience with personal computers, keyboard and multi‑system navigation, and MS Office Suite (Outlook, Word, Excel, SharePoint).
• 2+ years experience in children’s mental health, child welfare, developmental disabilities, juvenile justice, or related public‑sector human services, providing community‑based services to children, youth, and families.
• 2+ years experience in one or more areas: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development.
• 2+ years experience with Ohio delivery systems, including local community networks and resources.
• Willingness and ability to travel up to 50% of the time and work beyond core business hours as needed.

Preferred Qualifications

• Case management and discharge planning experience.
• Managed care and Medicaid experience.
• Residence in one of the preferred counties (Marion, Crawford, Sandusky, Summit, Cuyahoga, Portage, Geauga, Lake, Ashtabula, Stark, or Belmont).
• Bachelor’s or non‑licensed master’s degree in behavioral health, human services, health services, public health, psychology, social work, marriage and family therapy, counseling, or juvenile justice.

Pay

Base hourly rate or annual salary range: $21.10 – $40.90. Actual offer depends on experience, education, geography, and other factors. Position is eligible for CVS Health bonus, commission, or short‑term incentive program.

Benefits

Comprehensive benefits package for full‑time employees, including medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and additional resources based on eligibility.

Schedule

40 hours per week, Monday‑Friday 8 am‑5 pm with flexibility to work later as needed. Travel up to 50% of the time within Northeast Ohio; occasional travel to New Albany office.