BH HARP Recertification CMA

MetroPlusHealth; New York (NY); Remote; USD 55,000 - 75,000; Full time

Job summary

MetroPlusHealth is seeking a Behavioral Health HARP Recertification Care Management Associate to support eligibility maintenance recertification activities and member outreach for the HARP population. You will act as a liaison between members, care managers, providers, and community partners to ensure timely assessments, recertifications, and enrollment-related activities.

In this non-clinical role, you will create and maintain cases in care management systems, track outreach, document

Qualifications

• High school diploma or GED required.
• At least 1 year of professional experience in healthcare, managed care, customer service, care coordination, or case management preferred.
• Proficient in Word, Excel, Outlook, and Teams.
• Bilingual skills preferred (Spanish, Mandarin, Cantonese, Russian, French, Creole).
• Knowledge of NYS Medicaid eligibility, enrollment, and renewal processes preferred.

Responsibilities

• Conduct outreach to HARP members to facilitate timely completion of recertification and eligibility activities.
• Monitor and track HARP recertification due dates and maintain accurate records of member outreach and status updates.
• Support the collection and documentation of required information necessary for HARP enrollment, recertification, and continued eligibility.
• Serve as a liaison between members, providers, Health Homes, and internal departments regarding HARP eligibility and recertification requirements.
• Coordinate with Behavioral Health Care Managers to ensure that required assessments and documentation are completed within established timeframes.
• Create and maintain cases, tasks, and events within designated care management systems.
• Review and update member records to ensure documentation accuracy and regulatory compliance.
• Track and monitor member admissions, discharges, emergency room visits, and other significant events impacting HARP eligibility or service needs.
• Document outreach activities, member interactions, and enrollment-related communications in applicable systems.
• Assist members with navigation of benefits and access to healthcare and community-based services.
• Collaborate with Care Managers and leadership to identify members at risk of losing HARP eligibility and support retention efforts.

Skills

Integrity and Trust

Teamwork

Customer Service

MS Office

Education

High School Diploma

Marketplace Facilitated Enroller certification

Tools

Microsoft Office Suite

Job description

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlusHealthprovides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealthnetwork includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealthhas been committed to building strong relationships with its members and providers.

Position Overview

The Behavioral Health HARP Recertification Care Management Associate (CMA), under the direction of the Behavioral Health Quality and Retention Team Lead, is responsible for supporting HARP eligibility maintenance recertification activities, and member outreach efforts for the Behavioral Health HARP population. The role serv as a key liaison between members, Care Managers, providers, and community partners to ensure timely completion of HARP assessments, recertifications, enrollment-related activities, and member engagement initiatives.

The BH HARP Recertification CMA assists Behavioral Health Care Managers with non-clinical functions including case creation, tracking outreach activities, maintaining documentation, coordinating recertification requirements, supporting HARP enrollment processes, and facilitating communication with members and providers to ensure continuity of care and access to HARP services.

Work Shifts

9:00 AM - 5:00 PM

Duties & Responsibilities

• Conduct outreach to HARP members to facilitate timely completion of required recertification and eligibility activities.
• Monitor and track HARP recertification due dates and maintain accurate records of member outreach and status updates.
• Support the collection and documentation of required information necessary for HARP enrollment, recertification, and continued eligibility.
• Serve as a liaison between members, providers, Health Homes, and internal departments regarding HARP eligibility and recertification requirements.
• Coordinate with Behavioral Health Care Managers to ensure that required assessments and documentation are completed within established timeframes.
• Create and maintain cases, tasks, and events within designated care management systems.
• Review and update member records to ensure documentation accuracy and regulatory compliance.
• Track and monitor member admissions, discharges, emergency room visits, and other significant ever impacting HARP eligibility or service needs.
• Document outreach activities, member interactions, and enrollment-related communications in applicable systems.
• Assist members with navigation of benefits and access to healthcare and community-based services.
• Collaborate with Care Managers and leadership to identify members at risk of losing HARP eligibility and support retention efforts.
• Perform other duties as assigned by the Behavioral Health Quality and Retention Team Lead or
• Behavioral Health Management Team.

Minimum Qualifications

• High School diploma or High School Equivalency (GED); and
• Minimum of one (1) year of satisfactory full-time professional work experience.
• Experience in healthcare, managed care, customer service, care coordination, or case management preferred.
• Demonstrated ability to accurately document member interactions and maintain detailed records.
• Basic proficiency in Microsoft Word, Excel, Outlook, and Teams.
• Bilingual skills (Spanish, Mandarin, Cantonese, Russian, French, Creole) preferred.
• Knowledge of NYS Medicaid eligibility, enrollment, and renewal processes preferred.
• Knowledge of HARP, Health Home, Behavioral Health, and HCBS programs preferred.

Licensure and/or Certification Required:

• Must possess current Marketplace Facilitated Enroller certification at the time of hire from New York State of Health.
• Must complete all required annual recertification as a Marketplace Facilitated Enroller.

Professional Competencies:

• Integrity and Trust
• Teamwork and Problem-Solving Attitude
• Customer Service
• Superior Technical Computer skills (Microsoft Office including Excel, Word, Outlook, PowerPoint, Care Connect, Teams)
• Clear and Concise Written/Oral Communications
• Strong analytical and organizational skills
• Ability to work independently in a fast-paced environment with changing priorities.
• Exceptional Organizational and Communication Skills.
• Strong interpersonal and assessment skills
• Strong organizational and follow-up skills with the ability to manage multiple priorities and deadlines.
• Excellent verbal and written communication skills.

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