Care Management Associate - OhioRISE - Must reside in Ohio

4004 Aetna Medicaid Administrators; Ohio; Híbrido; USD 25.000 - 49.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Comprehensive benefits package

Paid time off

Wellness programs

Descripción de la vacante

CVS Health is seeking a Care Management Associate for the OhioRISE program. This full-time remote role interfaces with care coordination teams across Ohio to manage referrals, verify Medicaid eligibility, and complete health risk assessments for members.

The CMA serves as a front desk for the program, balancing compassion with professional efficiency. You will work in a varied, data-heavy environment, using EHR systems and Excel to support operations, while maintaining HIPAA compliance and

Formación

• Must be able to pass the CANS assessment and obtain certification within 90 days of employment.
• Experience in Ohio Medicaid or MCO settings preferred.
• Ability to balance compassion with efficiency in a fast-paced environment.

Responsabilidades

• Serve as front desk for the OhioRISE program and Care Coordination department.
• Take referrals for OhioRISE and verify Medicaid eligibility.
• Process referrals and complete Health Risk Assessments for assigned members.
• Respond to inquiries from members, guardians, and care partners; maintain HIPAA compliance.

Conocimientos

Critical thinking

Detail orientation

Multitasking

Time management

Communication

Remote work readiness

Educación

Associates degree or healthcare certifications

HS Diploma or GED

Herramientas

Electronic Health Records (EHR)

Excel

Descripción del empleo

Company Overview

We’re building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

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, administrative, and operational support partner to the Care Coordination department. This individual will work on a variety of administrative tasks to assist the Care Coordination department that may include but are not limited to, the 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 members assigned.

It is imperative that the CMA must be able to practice a high level of professionalism, adaptability, accountability, and emotional intelligence at all times when interacting with various departments or member representatives. Candidates must be able to effectively manage competing priorities, maintain accuracy in a fast-paced environment, and adapt quickly as operational needs and program priorities evolve. 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. Successful candidates will demonstrate strong time management skills, initiative, attention to detail, critical thinking and the ability to work independently while maintaining consistent communication and collaboration with team members and leadership. Individuals in this role must also demonstrate accountability for information shared and workflows completed, even in environments where processes and guidance may change rapidly. Because this role supports vulnerable populations and families navigating complex systems, the ability to balance compassion with efficiency and professionalism is essential at all times. Candidates must maintain confidentiality and comply with all HIPAA and organizational privacy requirements.

Location & Schedule

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 the CANS assessment and obtain certification within 90 days of employment. It is essential that staff must be able to demonstrate and articulate in an interview how they meet the qualifications below:

• Ability to articulate strength in the area of critical and quick thinking
• Detail oriented for the purpose of manual data entry.
• Ability to handle escalated calls
• Problem solving skills in stressful situations
• Ability to multitask in multiple systems at one time
• Ability to take initiative and accountability in own learning
• Ability to articulate how you contribute to a positive work environment
• Ability to independently manage time and assigned tasks

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

Education

Education HS Diploma, GED or Equivalent

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $18.50 - $35.29. 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.

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

Application Window

We anticipate the application window for this opening will close on: 11/30/2026

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

Company Culture

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.