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Care Coordinator (Illinois Medicaid)

Humana

Humana

McLean, VA, USA · Indianapolis, IN, USA · Chicago, IL, USA · Atlanta, GA, USA · Orlando, FL, USA · Washington, DC, USA · Charleston, SC, USA · Dover, DE, USA · Newport, RI, USA · Pittsburgh, PA, USA · Sacramento, CA, USA · Oklahoma City, OK, USA · Tucson, AZ, USA · Albany, NY, USA · Huntsville, AL, USA · Albuquerque, NM, USA · Jersey City, NJ, USA · Las Vegas, NV, USA · Omaha, NE, USA · New York, NY, USA · St. Louis, MO, USA · Jackson, MS, USA · Boston, MA, USA · Philadelphia, PA, USA · New Orleans, LA, USA · Remote
Posted on Monday, July 31, 2023

Description

Humana Gold Plus Integrated is seeking Care Coordinators to assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families towards and facilitate interaction with resources appropriate for the care and wellbeing of members.

*** $2000 SIGN-ON BONUS for new associates! $2000 payable following 90 days employment. ***

Responsibilities

The LTSS Care Coordinator employs a variety of strategies, approaches and techniques to manage a member's health issues. The Care Coordinator understands own work area professional concepts/standards, regulations, strategies, and operating standards, and makes decisions regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

The Care Coordinator responsibilities are as follows:

  • Ensures members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs.
  • Identifies and resolves barriers that hinder effective care.
  • Plan and implement interventions to meet care needs.
  • Coordinates services, monitors, and evaluates the case management plan against the member's personal goals.
  • Ensures the patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning.
  • Guides members/families towards resources appropriate for their care. Services are driven by facilitating interactions with other payer sources, providers, interdisciplinary teams, and others involved in the member’s care as appropriate and required by our comprehensive contract.
  • Visit Medicaid members in their homes, Assisted Living Facilities, and/or Long-Term Care Facilities and other care settings – 75-90% local travel (see Additional Information section).

Required Qualifications

The Care Coordinator must meet one (1) of the following requirements:

  • Bachelor’s degree in social sciences, social work, human services, or a related field.
  • In lieu of Bachelor’s degree – one (1) year of experience in long term care, hospital and/or Medicare/Medicaid Program experience, plus a minimum of two (2) years of experience conducting comprehensive assessment of the elderly population.
  • Unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly.
  • Licensed Professional Counselor (LPC).
  • Licensed Social Worker (LSW).

The Care Coordinator must meet all following requirements:

  • Must reside in the State of Illinois.
  • 1-year experiences in health care and/or case management.
  • 1-year experience with Medicare & Medicaid recipients and/or long-term care and/or Home and Community based services and/or working with managed care organizations.
  • Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.
  • Ability to use a variety of electronic information applications/software programs including electronic medical records.
  • Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
  • This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
  • This role is part of Humana’s Driver safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

Work at Home Requirements

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Additional Information

  • Workstyle/Travel: This is a Field position that requires 75 - 90% travel in the field to visit members.
  • Work Schedule: Monday - Friday; 8am - 5pm CST but open to flexible work schedule. Possibility of working additional hours based on business needs.
  • Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes; 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

#LI-Remote

Scheduled Weekly Hours

40