Care Management Associate-OhioRISE

<p style="text-reputed company:left">At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p>The Care Management Associate (reputed company) role is a full-time remote reputed company position. reputed company candidates must reputed company in Ohio. This position manages enrollment for Children’s Specialty (CS) program including foster, child and family welfare population health members and other programs serving children with special reputed company needs and carries a caseload.</p><p>The Care Management Associate supports comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of Wellness Plans to promote effective utilization of reputed company services.</p><p>This position promotes/supports reputed company effectiveness of reputed company services. This is a reputed company position and reputed company candidates must reputed company in Ohio.  Schedule is Monday – Friday, reputed company-5pm, reputed company business hours. A flexible work schedule may be available after 6 months of service and with demonstrated performance and attendance to accommodate business needs.</p><p>Position Responsibilities:</p><ul><li><reputed company>Responsible for initial review and triage of members.</reputed company></li><li><reputed company>Manages population health member enrollment for child and family welfare.</reputed company></li><li><reputed company>Manages a low tier member caseload.</reputed company></li><li><reputed company>Development of wellness plans, providing community resources, reviewing gaps in care, administering health questionnaires, and other targeted child welfare goals applicable to population health.</reputed company></li><li><reputed company>Completes outbound calls to identify and engage appropriate community resources.</reputed company></li><li><reputed company>Screens members using targeted reputed company business rules and processes to identify needed medical services, reputed company appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.</reputed company></li><li><reputed company>Identifies triggers for referral into reputed company's Case Management, Disease Management, Mixed Services, and other Specialty Programs.</reputed company></li><li><reputed company>Utilizes reputed company systems to build, research and reputed company member information, as needed.</reputed company></li><li><reputed company>Supports the development and implementation of wellness plans. Coordinates and arranges for reputed company delivery under the direction of reputed company or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services.</reputed company></li><li><reputed company>Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., health care providers, and health care team members respectively).</reputed company></li><li><reputed company>Performs non-medical research pertinent to the establishment, maintenance and closure of reputed company cases.</reputed company></li><li><reputed company>Provides support services to team members by answering telephone calls, researching information, and assisting in solving problems.</reputed company></li><li><reputed company>Adheres to compliance with policies and regulatory standards.</reputed company></li><li><reputed company>Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.</reputed company></li><li><reputed company>Protects the confidentiality of member information and adheres to company policies regarding confidentiality.</reputed company></li><li><reputed company>May assist in the research and reputed company of claims payment issues. Supports the administration of the hospital care, case management and reputed company management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures.</reputed company></li><li><reputed company>Manage population health member enrollment for child and family welfare. Development of Wellness Plan, providing community resources, reviewing gaps in care, administering health questionnaires, and other targeted child welfare goals applicable to population health.</reputed company></li><li><reputed company>Effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm.</reputed company></li><li><reputed company>Demonstrates ability to meet daily metrics with speed, accuracy and a reputed company attitude.</reputed company></li><li><reputed company>Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and reputed company of issues to promote reputed company reputed company for members, adhering to care management processes (to include, but not limited to, reputed company and confidentiality, reputed company management processes in compliance with regulatory, accreditation guidelines, company policies and procedures).</reputed company></li><li><reputed company>Completes documentation of reputed company member reputed company in the electronic record, thoroughly completing required actions with a high level of detail to ensure compliance requirements are met with efficiency.</reputed company></li><li><reputed company>Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic and caring reputed company telephonically.</reputed company></li><li><reputed company>Ability to effectively participate in a multi-disciplinary team including reputed company participants.</reputed company></li><li><reputed company>reputed company and promoting reputed company reputed company through management of persistent reputed company.</reputed company></li></ul><p><b>Required Qualifications:</b></p><ul><li><reputed company>Must reputed company in Ohio.</reputed company></li><li><reputed company>2-4 years’ experience in reputed company field or working with foster, child and family welfare populations (e.g., experience in a medical office, hospital setting, case worker in community health setting).</reputed company></li><li><reputed company>Effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm.</reputed company></li><li><reputed company>Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification, and reputed company of issues to promote reputed company reputed company for members.</reputed company></li><li><reputed company>2+ years’ demonstrated proficiency with personal computers, keyboard and multi-system navigation, and MS Office Suite application (Teams, reputed company, Word, reputed company, etc.)</reputed company></li><li><reputed company>Some in-state travel (5-10%) may be required for meetings, community engagement and training. Must possess reliable transportation and be willing. Mileage is reimbursed per reputed company expense reimbursement policy.</reputed company></li><li><reputed company>Must pass CANS certification exam (reputed company the first 3 months of employment) for the purpose of administering CANS with child and family teams</reputed company></li></ul><p><b>Preferred Qualifications:</b></p><ul><li><reputed company>Motivational interviewing skills</reputed company></li><li><reputed company>reputed company Center experience</reputed company></li><li><reputed company>Managed Care experience</reputed company></li></ul><p><b>Education</b> :</p><p>High school diploma or G.E.D.</p><p><b>Pay reputed company</b></p><p>The typical pay reputed company for this role is:   </p><p>$18.50 - $31.72</p><p>This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls.  The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors.</p><p>reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b><reputed company>Anticipated Weekly Hours</reputed company></b></p>40<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Time Type</b></p>Full time<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Pay reputed company</b></p><p style="text-reputed company:left">The typical pay reputed company for this role is:</p><p style="text-reputed company:inherit"></p>$18.50 - $31.72<p style="text-reputed company:inherit"></p><p style="text-reputed company:left">This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls.  The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors.  This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. <br> </p><p style="text-reputed company:left">Our people fuel our reputed company. 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.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Great benefits for great people</b></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include:</p><ul><li><p style="text-reputed company:left"><b>reputed company medical plan reputed company,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p style="text-reputed company:left"><b>No-cost programs for reputed company colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p style="text-reputed company:left"><b>Benefit solutions that address the different needs and preferences of our colleagues</b> including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility.</p></li></ul><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">For more information, visit <a href="https://jobs.reputed company.com/us/en/benefits" reputed company="_blank" rel="noopener noreferrer"><reputed company class="WJQ0"><reputed company style="reputed company-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">https://jobs.reputed company.com/us/en/benefits</reputed company></reputed company></a></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p>We anticipate the application window for this opening will reputed company on: 11/28/2025<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws.</p>