Job Description This is a full time office based position with some work from home flexibility. Must reside in Ohio. The Transition of Care Coordinator is responsible for oversight and management of clinical team processes including the organization and development of high performing teams.
Fundamental Components: â¢ Reinforces clinical philosophy, programs, policies and procedures. â¢ Communicates strategic plan and specific tactics to meet plan. â¢ Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. â¢ Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. â¢ Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes. â¢ Accountable for meeting the financial, operational and quality objectives of the unit. â¢ Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors. â¢ May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. â¢ Consistently demonstrates the ability to serve as a model change agent and lead change efforts. â¢ Accountable for maintaining compliance with policies and procedures and implements them at the employee level. â¢ Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.
Specific to the OHRise contract, responsibilities include but are not limited to:
1. Serves as the primary point of contact with MCOs and with state agency staff for planning, managing, and troubleshooting transition issues as members' transition from MCOs into the OhioRISE Plan or back to the MCOs. Serves as the OhioRISE Plan's primary point of contact for planning and managing all member transitions of care as identified in Appendix D, Care Coordination, and transitions resulting from OhioRISE Plan's enrollments and disenrollments. 2. The primary functions of the OhioRISE Plan's Transition of Care Coordinator include but are not limited to: a. Development of OhioRISE Plan's policies and procedures for successful transition of members to and from MCOs in alignment with state requirements; b. Primary point of contact for OhioRISE Plan's staff, ODM, MCO representatives, and other state agency staff for transition of care issues; and c. Interface with Regional Coordinators to ensure member transitions of care include local resources and input as needed.
Required Qualifications .â¢ Active unrestricted State Licensure in applicable functional area. (e.g. RN, LPC, LCSW) â¢ 2+ years of previous leadership or supervisory experience required â¢ 5-7 years in clinical area of expertise. â¢ Demonstrated proficiency with personal computer, keyboard navigation, and MS Office Suite applications. â¢ Ability to travel as needed, anticipate mostly in-state. Must have reliable transportation, valid/active drivers license, and proof of vehicle insurance. â¢ Minimum of two years' experience managing or coordinating children's mental health, child welfare, developmental disabilities, juvenile justice, or a related public sector human services or behavioral health care field, providing community-based services to children and youth and their family/caregivers; â¢ Background and 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; â¢ Be clinically and culturally competent/responsive with training and experience necessary to manage complex cases in the community across child-serving systems. â¢ Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm, is required
Preferred Qualifications If RN, BSN degree is preferred.
Education â¢ Master's degree in behavioral health field or If RN, minimum of associates degree.
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.
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Internal Number: 1689555BR
About CVS Health
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CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.
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