Medicaid Case Management Analyst - Data-Driven Ops

cai; Delaware; On-site; USD 42,000 - 66,000; Full time

Job summary

CAI, a global services firm, is seeking a Case Management Analyst to support the Medicaid team onsite in Newark, DE. This role emphasizes data entry, client interaction, and process optimization in a fast-paced environment.

Responsibilities include following federal/state Medicaid requirements, routing cases, and maintaining accurate documentation in the eligibility system. One Saturday per month may be required; sponsorship is not provided.

Qualifications

• High school diploma or equivalent required.
• At least 1 year of data entry experience.
• At least 1 year of customer service experience.
• Proficiency with databases, spreadsheets, and Microsoft Office Suite.
• Ability to manage multiple priorities in a fast-paced environment while maintaining accuracy and organization.
• Strong analytical and problem-solving skills with the ability to identify issues and implement effective solutions.
• Professional written and verbal communication skills for interaction with internal teams and external clients.
• Fluent English communication skills.
• Reliable transportation and consistent attendance.

Responsibilities

• Learn, understand, and follow federal and state laws, regulations, standards, policies, and Medicaid program requirements.
• Adhere to CAI and client security requirements.
• Utilize computer inquiry systems to obtain required verifications.
• Retrieve Medicaid applications from the client system and distribute work among team members daily.
• Identify additional benefits and route cases to appropriate processing queues.
• Document case management activities and updates within the eligibility system.
• Answer and direct phone calls, respond to emails and correspondence, and serve as a point of contact for clients.
• Monitor case completion activity within client systems.
• Index verifications and renewals as required.
• Track monthly operational metrics and present results to leadership.
• Conduct weekly audits of assigned cases to ensure completion and accuracy.
• Monitor shared resource mailboxes to ensure work is assigned and completed efficiently.
• Attend individual and team meetings to stay informed of process and policy updates.
• Perform additional case management and operational responsibilities as assigned.

Skills

Data entry

Customer service

Databases

Spreadsheets

Microsoft Office

Multitasking

Analytical thinking

Communication skills

Fluent English

Reliability/attendance

Education

High school diploma or equivalent

Job description

CAI, a global services firm, is seeking a Case Management Analyst to support the Medicaid team onsite in Newark, DE. This role emphasizes data entry, client interaction, and process optimization in a fast-paced environment.

Responsibilities include following federal/state Medicaid requirements, routing cases, and maintaining accurate documentation in the eligibility system. One Saturday per month may be required; sponsorship is not provided.