Adult Family Home Certifier

Humana • Work at Home - Wisconsin, WI

8d • $58,700 - $70,400 • Remote

About The Position

Join our team in this exciting role as Residential Adult Family Home (AFH) Certifier. Reporting to the Supervisor of Provider Engagement, you will oversee the certification of new and existing 1-2 bed adult family homes in iCare/Humana network. You will cultivate our social community through community advocacy programs and active engagement with community members. You will travel throughout Southwestern WI working with our providers.

Requirements

• Bachelor's degree
• 1 year of experience understanding the requirements for Residential Providers.
• Must reside within the State of WI or commutable to Southwest, WI within approximately 30 mins
• Able to travel 50-60% of your time throughout Southwest, WI region

Nice To Haves

• 1 or more years of experience in Managed Care
• Knowledge of Medicaid standards for 1-2 bed Adult Family Homes and all related and reference standards.

Responsibilities

• Sustain positive working relationships with team members and provide excellent customer service to certified 1-2 bed Adult Family Home (AFH) providers to support the vision for residential transformation.
• Ensure compliance with the Medicaid Standards for Certified 1-2 Bed Adult Family Homes during the certification and recertification of assigned AFH's.
• Screen provider documentation to check eligibility to become certified.
• Independently complete Adult Family Home certification process for all new homes in assigned region of the network.
• Annually re-certify all certified AFH's in assigned service region, maintaining timely and thorough completion of all necessary documentation.
• Verify and document that you correct all cited areas of non-compliances or areas of the standards that you must bring into compliance before you issue a certification.
• Maintain experience of the Medicaid Standards for Certified 1-2 Bed Adult Family Homes and DHS contract language about certified AFH expectations for providers and MCO staff.
• Lead efforts around any provider plans of correction, terminations or revocation of certification.
• Ensure a network of certified adult family homes that increases community connections, supports member choice and dignity, and fosters full participation in communities.
• Participate in ongoing training; maintain up-to-date knowledge to ensure compliance with Medicaid Standards and organizational practices.
• Must travel within assigned region to complete certifications and recertification's.
• Ability to visit homes on an emergent basis.

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level