Job description

Our client, a Retail Pharmacy company, is looking for a Healthcare Consultant I - CMA for their Remote location.

Responsibilities:

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.

Requirements:

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.
Minimum 1 year of relevant experience, outbound calls, experience in fast- paced healthcare setting
HA diploma or GED equivalent

Why Should You Apply?

Health Benefits
Referral Program
Excellent growth and advancement opportunities

Healthcare Consultant I – CMA

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