Care Management Associate - OhioRISE (Must live in Ohio)

CVS Health; Columbus (OH); Remote; USD 60,000 - 80,000; Full time

Job summary

CVS Health seeks a Care Management Associate for its OhioRISE program. This role involves engaging with care coordinators and managing inquiries while supporting administrative needs in a telework position. Candidates must have prior experience in managed care and demonstrate problem-solving and multitasking skills to succeed in this full-time position.

Benefits

Affordable medical plan options

401(k) plan with company matching

Employee stock purchase plan

Wellness screenings and counseling services

Qualifications

• Must pass CANS assessments certification within 90 days.
• Recent experience with MCOs in Ohio preferred.

Responsibilities

• Manage inbound care management queue and respond to inquiries.
• Confirm Medicaid eligibility and process referrals.
• Complete Health Risk Assessments for assigned members.

Skills

Problem solving

Multi-tasking

Communication

Education

High School Diploma, GED or Equivalent Experience

Job description

Care Management Associate - OhioRISE (Must live in Ohio)

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Care Management Associate - OhioRISE (Must live in Ohio)

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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

OhioRISE manages the behavioral health benefit for eligible children and young adults receiving Medicaid services in Ohio. The CMA will regularly interface with various groups around the state who are providing care coordination services or supporting the services that are utilized by our membership. This can include but are not limited to, care coordinators, managers, community members, referral sources, children services, children/young adults, guardians, family members, case managers, behavioral health providers, etc.

This role serves as the "Front desk" to the OhioRISE plan. This individual will work on an inbound care management queue line, responding to questions and inquiries from both members/guardians or parties assisting with services. They will be responsible for taking referrals for OhioRISE, confirming their Medicaid eligibility and processing the referral. This role will also complete Health Risk Assessments for all for members assigned. It is imperative that the CMA must be able to practice both a high level of professionalism and compassion at all times when interacting with various departments or member representatives. The CMA will also support administrative needs that involve comfortability with working in complex data systems, an Electronic Record System and/or Excel at any given time. Tasks can change with little notice to meet the demands of the health plan requiring flexibility.

The Care Management Associate (CMA) role is a full-time remote telework position. Qualified candidates must reside in Ohio. Schedule is Monday – Friday, 8am-5pm, standard business hours. No required holidays or weekends. Candidates must have a private location to complete all work that is free from distractions or other individuals. You will need to secure your own internet but, your equipment will be provided to you prior to your first day.

Required Qualifications

Recent experience working for other MCOs, specifically within the last 5-7 years in the state of Ohio. Experience may be replaced with recent employment with healthcare organizations or companies. Must be able to pass and obtain CANS assessments certification within 90 days of employment.

Qualifications

It is essential that staff must be able to demonstrate and articulate in an interview how they meet the qualifications below:

• Ability to handle escalated calls
• Problem solving skills in stressful situations
• Ability to multitask in multiple systems at one time
• Ability to take initiative in own learning
• Ability to articulate how you contribute to a positive work environment
  
  

Preferred Qualifications

• Associates degree, or other specialized health care certifications or training.
• Desire and interest in helping individuals with behavioral health care needs
  
  

Education

HS Diploma, GED or Equivalent Experience

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$18.50 - $31.72

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great Benefits For Great People

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
  
  

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

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