Care Coach

Humana

2d•Remote

About The Position

Become a part of our caring community The Care Coach directly contributes to improved health outcomes and service efficiency for the D-SNP population. You will evaluate member's needs to achieve and maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. You will report to a Manager of Health Services. The Care Coach employs a variety of strategies and techniques to support a member's wellness state by coordinating services and resources. Resolve barriers that hinder care. Ensure patients progress towards desired outcomes by overseeing patient care through use of assessment, data, conversations with member, and active care planning. Facilitate the identification and referral process for members to ensure access to appropriate services. Promote communication among healthcare providers to enhance care delivery. Coordinate services to avoid duplication and to ensure that all member health needs are addressed. Be a primary contact for external partners and agencies, providing updates on member status and services. The Care Coach collaborates with D-SNP coordinators to support value-added benefits and DSNP comprehensive member rounding, thereby ensuring holistic case management for dual-eligible individuals. NOTE: This is a Field position where travel is required. Travel will be up to 25% of the time within the state.

Requirements

Must have a license as a Social Worker, LPN, or RN
Must reside in South Carolina
2 or more years of case management or care coordination experience
Knowledge of MS Office including Word and Excel
Exceptional verbal/written communication and interpersonal skills
Use a variety of electronic information applications/software programs
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: 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.
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.
This role is part of our company'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. 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.

Nice To Haves

Experience with Medicaid or Medicare

Responsibilities

Evaluate member's needs to achieve and maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
Employ a variety of strategies and techniques to support a member's wellness state by coordinating services and resources.
Resolve barriers that hinder care.
Ensure patients progress towards desired outcomes by overseeing patient care through use of assessment, data, conversations with member, and active care planning.
Facilitate the identification and referral process for members to ensure access to appropriate services.
Promote communication among healthcare providers to enhance care delivery.
Coordinate services to avoid duplication and to ensure that all member health needs are addressed.
Be a primary contact for external partners and agencies, providing updates on member status and services.
Collaborates with D-SNP coordinators to support value-added benefits and DSNP comprehensive member rounding, thereby ensuring holistic case management for dual-eligible individuals.