Care Coordinator (Transition/Custodial Prevention)

Care Coordinator/Care Coach 2

The Care Coordinator/Care Coach 2 (Transition/Custodial Prevention Specialist) assesses and evaluates member needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and wellbeing of members. The Care Coordinator/Care Coach 2 work assignments are often straightforward and of moderate complexity.

The Care Coordinator/Care Coach 2 (Transition/Custodial Prevention Specialist) will meet members in the field at home, Nursing Facility (NF) or location of the member's choice, spending quality time assessing their goals, needs and barriers and then connecting members with quality services to promote their ultimate well-being and drive person-centered health outcomes.

Responsibilities include:

• Provides specialized support for members receiving Long Term Services and Support (LTSS), with a focus on addressing health-related social needs (HRSNs), providing psychosocial support, and ensuring LTSS meets the member's service needs.
• May support members residing in NFs by building relationships with facility staff, advocating for member care (including access to needed behavioral health services), and assessing the member's desire and ability to return to the community.
• Contacts members telephonically and face-to-face to establish goals and priorities, evaluate resources, develop plans of care, and identify LTSS providers and community partnerships to provide a combination of services and supports that best addresses the needs and goals of members and caregivers through person centered thinking approaches.
• Focuses on supporting members and/or caregivers utilizing an interdisciplinary approach in accessing long term services and support, social, housing, educational and other services, regardless of funding sources to meet their needs.
• Develops and modifies Individual Service Plans and involve applicable members of the care team in care planning (Informal caregiver coach, PCP, etc.).
• Supports members through navigation of their LTSS and related environmental and social needs.
• Utilize available information pertaining to members to prevent the need for administration of duplicative assessments.
• Make recommendations for appropriate Home and Community-Based Services (HCBS) to enable member's independence in the community.
• Facilitates interactions with other payer sources, providers, and interdisciplinary care teams.
• Educates members in maintaining Medicaid eligibility.
• Assist with entry of annual Level of Care assessment into state portal.

Required Qualifications

• Applicants must reside in Northern Cook County, DuPage County or Kane County, Illinois or within a 10-mile radius of these areas/borders in a neighboring county.
• Bachelor's degree in social sciences, social work, human services, or a related field.
• Two (2) years of prior experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services (HCBS), and/or managed care organizations.
• One (1) or more years of professional experience working with members in custodial and transitional care.
• Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.
• Exceptional oral and written communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
• Proven ability of critical thinking, organization, and problem-solving skills.
• Ability to manage multiple or competing priorities in a fast-paced environment.
• Ability to use a variety of electronic information applications/software programs including electronic medical records.
• This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• Ability to travel in the region to meet face to face with members and/or their families, community partners and care teams.
• This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance.

Preferred Qualifications

• An active, unrestricted Licensed Professional Counselor (LPC), Licensed Social Worker (LSW) or Registered Nurse (RN) in Illinois.
• Nursing home diversion or long-term care case management experience.
• Experience working with a Waiver Program.
• Experience with Medicare & Medicaid recipients.
• Experience working with complex health population.
• Experience with health promotion, coaching and wellness.
• Knowledge of community health and social service agencies and additional community resources.
• Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. See "Additional Information" section for language assessment information.

Additional Information

• Workstyle: This is a Field position - Employees perform their core duties at noncompany locations, such as providing services at business partner facilities or prospects' and members' homes.
• Travel: 75 - 90% field-based interactions with members and/or their families, community partners and care teams. May need to attend occasional onsite meetings in Humana's Schaumburg, IL office.
• Work Schedule: Monday - Friday; 8:00 AM - 5:00 PM Central Standard Time (CST), with flexibility available. Additional hours may be required based on business needs.
• Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us Humana Inc. (NYSE: HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.