Care Management Associate - OhioRISE - Must reside in Ohio

CVS Health•Dayton, OH

18h•$19 - $35•Remote

About The Position

The Care Management Associate (CMA) supports OhioRISE, which manages the behavioral health benefit for eligible children and young adults receiving Medicaid services in Ohio. The role regularly interfaces with care coordinators, managers, community members, referral sources, children’s services, members and their families or guardians, case managers, behavioral health providers, and others involved in care or services. The CMA serves as a front desk and administrative and operational support partner for the Care Coordination department. The position handles a range of administrative and care-management support tasks, including working with the inbound care management queue, responding to inquiries from members, guardians, and service partners, taking OhioRISE referrals, confirming Medicaid eligibility, processing referrals, and completing Health Risk Assessments for assigned members. The CMA uses complex data systems, an Electronic Record System, and/or Excel, and must adapt as tasks and program priorities change. The role calls for professionalism, adaptability, accountability, emotional intelligence, sound judgment, and the ability to manage competing priorities accurately in a fast-paced environment. The CMA works independently while communicating and collaborating consistently with colleagues and leadership, maintains confidentiality, and complies with HIPAA and organizational privacy requirements. Compassion, efficiency, and professionalism are important when supporting vulnerable populations and families navigating complex systems. This is a full-time remote telework position for candidates who reside in Ohio. The schedule is Monday through Friday, 8 a.m. to 5 p.m., with no required holidays or weekends. Candidates must have a private, distraction-free location for work and provide their own internet; equipment will be provided before the first day.

Requirements

Recent experience working for another MCO in Ohio within the last 5–7 years; this experience may be replaced by recent employment with a healthcare organization or company.
Must pass the CANS assessment and obtain certification within 90 days of employment.
Demonstrated critical and quick-thinking ability.
Attention to detail for manual data entry.
Ability to handle escalated calls.
Problem-solving skills in stressful situations.
Ability to multitask across multiple systems at once.
Ability to take initiative and accountability for one’s own learning.
Ability to explain how one contributes to a positive work environment.
Ability to independently manage time and assigned tasks.
High school diploma, GED, or equivalent experience.
Must reside in Ohio.
Must have a private, distraction-free location for work and secure personal internet access.
Must maintain confidentiality and comply with HIPAA and organizational privacy requirements.

Nice To Haves

Associate degree or other specialized healthcare certifications or training.
Desire and interest in helping individuals with behavioral health care needs.

Responsibilities

Serve as the front desk and administrative and operational support partner for the Care Coordination department.
Work with the inbound care management queue and respond to questions and inquiries from members, guardians, and parties assisting with services.
Take OhioRISE referrals, confirm Medicaid eligibility, and process referrals.
Complete Health Risk Assessments for assigned members.
Perform administrative support tasks using complex data systems, an Electronic Record System, and/or Excel.
Manage competing priorities and assigned tasks while maintaining accuracy and adapting to changing operational needs and program priorities.
Communicate and collaborate with team members and leadership, and maintain accountability for information shared and workflows completed.
Maintain confidentiality and comply with HIPAA and organizational privacy requirements.