Juvenile Justice Case Management Coordinator - Jefferson County, KY

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Position Summary:
Aetna Better Health is hiring for multiple openings across the state/regions of Kentucky. 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 is a field based position that requires regional in-state travel 80-90% of the time.

Qualified candidate must have reliable transportation. Travel to the Louisville office for meetings and training is also anticipated.

This position is assigned to the Jefferson Region.

Qualified candidates may reside in or adjacent to the assigned region.
Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm CST, is required.

We are serving the needs of children and families that may require working after school, after work, etc.

Evaluation of Members:

• Through the use of care management assessments and information/data review, recommends an approach to resolving care needs maintaining optimal health and well-being by evaluating member’s benefit plan and available internal and external programs/services.
• Identifies high risk factors and service needs that may impact member outcomes and implements early and proactive support interventions.
• Coordinates and implements Wellness care plan activities and monitors member care needs.
• 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.
• 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.
• 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.

Preferred Qualifications:

• Managed Care experience preferred.
• Case management and discharge planning 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).

Work from Home Requirements:

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.

• A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and

HIPAA guidelines, and allowing for uninterrupted work during work hours.

• Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.

• The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).

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