Job Description As part of the bold vision to deliver the âœNext Generationâ of managed care in Ohio Medicaid, Ohio RISE 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.
This is a full time telework position in Ohio. 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
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 If RN, BSN degree is preferred.
Education â¢ Master's degree in behavioral health field or If RN, minimum of associates degree.
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