Case Management Coordinator

Job DescriptionThis position is field-based and requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver's license, proof of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training.This position is assigned to the Two Rivers region and will cover the following counties: Warren, Simpson, Allen, Daviess, Butler, Barren, Hart, Ohio, Metcalfe, McLean, Webster, Union, Henderson, Hancock, Logan, Monroe, and Webster counties.Qualified candidates must reside in or adjacent to the assigned region.The Juvenile Justice Care Management Coordinator (CMC) utilizes critical thinking and clinical judgment to collaborate and implement the case management process, in order to facilitate appropriate juvenile justice and healthcare outcomes for members by providing advocacy, care coordination, support and education for members through the use of care management tools and resources.Evaluation of Members:-Through the use of care management tools and information/data review, conducts comprehensive assessment of member's needs/eligibility and recommends an approach to case resolution and/or meeting needs, including their legal, educational and biopsychosocial needs by evaluating member's benefit plan and available internal and external resources. 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/updates care plan to reflect progress that supports the optimal member health, wellness and compliance with juvenile justice system guidelines.-Collaborates with partners from the state and criminal justice systems to ensure that the member understand and fulfill their legal requirements.Enhancement of Medical Appropriateness and Quality of Care:-Using holistic approach consults with case managers, supervisors, Medical Directors and/or other 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.-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 and wellbeing.-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.-Help members actively and knowledgably participate with partners within the Juvenile Justice and court systems to decrease recidivism rates and gain access to needed services and supports.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.Required QualificationsMinimum 1 year of experience in behavioral health, social services or juvenile justice.-Minimum 1 year of experience with MS office suite applications.-Willing and able to travel 80-90% of their time using their own vehicle to meet members face to face in Warren, Simpson, Allen, Daviess, Butler, Barren, Hart, Ohio, Metcalfe, McLean, Webster, Union, Henderson, Hancock, Logan, Monroe, and Webster counties KY and surrounding areas.-Valid Driver's License required.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- 6 months experience or detailed knowledge in:Foster Care systemsAdoption AssistanceDelivery of Behavior Health ServicesTrauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations.- 1+ year(s) experience and functional knowledge with the Juvenile Justice systems.-Case management and discharge planning experience preferred.-Managed Care experience preferred.EducationBachelor's degree with either degree being in Behavioral Health or a Human Services field of study required. A non-licensed Master level clinician with either degree being in Behavioral Health or a Human Services field of study preferred.Business OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-01