Care Coach- Service Facilitator for Consumer Directed Services

Humana • Roanoke, VA

7d • Hybrid

About The Position

Become a part of our caring community and help us put health first This role involves meeting members in the field at their home, Nursing Facility (NF) or location of the member's choice, spending quality time assessing their goals, needs and barriers and then connecting our members with quality services to promote their ultimate well-being and drive person centered health outcomes. Position Responsibilities: Initial Home Visit and Care Planning Member and Employer of Record (EOR) Training Timesheet and Service Verification Documentation and Compliance Ongoing Support and Monitoring Annual Medicaid Waiver Redetermination Availability and Member Support Back-Up Planning and Service Continuity Internal Collaboration Quality Assurance and Risk Management Use your skills to make an impact

Requirements

• Bachelor's degree in a health and human service field (such as Social Work, Nursing, Public Health, Psychology, or Human Services) OR LPN OR equivalent relevant direct care experience.
• Minimum of one year of experience in service facilitation or in a community-based setting supporting individuals with disabilities, children, or older adults.
• Must reside in Virginia (preferably Roanoke, upper Charlottesville, Harrisonburg and Winchester)
• The company requires successful completion of DMAS-approved service facilitator training and competency assessment within 90 days of hire. The minimum score for this assessment is 80%. Additionally, the employee must pursue ongoing recertification every five years. To do so, they must provide current certification.
• Proficiency in service facilitation best practices, including comprehensive understanding of Virginia state law and federal regulations related to Medicaid waivers and consumer-directed services.
• Familiarity with DMAS forms 97 AB, 98, 99, 100, 486, 488, 489, and FARF.
• Demonstrated competencies in assessing functional limitations, care planning, interviewing, documentation, cultural competence, and independent work.
• Commitment to privacy, safety, and compliance standards in accordance with corporate policies and all applicable federal and state regulations.
• Ability to manage confidential information with discretion and integrity, in compliance with HIPAA and organizational privacy standards.
• Experience working with electronic systems and proficiency in Microsoft Office applications, including Excel, Word, PowerPoint, and Teams.
• Maintain up-to-date personnel records, including documentation of all training, competency assessments, professional references, and background checks.
• Ensure completion and retention of criminal background checks and the Virginia Department of Social Services Child Protective Services Central Registry
• Verify that candidates are not debarred, suspended, or excluded from participation in federal healthcare programs, as confirmed through the LEIE database.
• Obtain/Maintain a notary public commission within 90 days of employment.
• Must be willing to travel at least 30-50% of the time within your assigned Region where you reside in Northern Virginia, to conduct field visits with members in your assigned area.
• Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Bilingual proficiency in English and another language.
• Experience working with Medicaid or managed care populations.
• Familiarity with Humana's electronic health record systems.
• Certification in case management (such as CCM, ACM, or equivalent) or progress toward such certification.
• Previous experience in telehealth or virtual care coordination environments

Responsibilities

• Initial Home Visit and Care Planning
• Member and Employer of Record (EOR) Training
• Timesheet and Service Verification
• Documentation and Compliance
• Ongoing Support and Monitoring
• Annual Medicaid Waiver Redetermination
• Availability and Member Support
• Back-Up Planning and Service Continuity
• Internal Collaboration
• Quality Assurance and Risk Management

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees