Case Management Coordinator

Job Description
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.

This 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 Salt River Trail Region (Anderson, Breckinridge, Bullitt, Franklin, Grayson, Hardin, Henry, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble, Washington, and Woodford counties). Qualified candidates must reside in or adjacent to the assigned region.

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 Qualifications
-Experience and functional knowledge with the Juvenile Justice systems.
-Experience or detailed knowledge of the Foster Care systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations, is required.
-2 years' experience in behavioral health, social services or juvenile justice.
-Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.
  • If you are 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 within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
-Case management and discharge planning experience preferred
-Managed Care experience preferred.

Education
-Minimum of a Bachelor's degree or a non-licensed Master level clinician is required; with either degree being in behavioral health or a relevant human services field of study required (social work, psychology, marriage and family therapy, counseling).

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.