Care Coach (Long-Term Services & Support)

Humana • Richmond, VA

1d • Remote

About The Position

Humana Healthy Horizons in Virginia is seeking Care Coaches (Care Coach 1) to assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness. This role involves guiding members and families toward and facilitating interaction with appropriate resources for their care and well-being. The Care Coach 1 role often handles straightforward and moderately complex work assignments. The position requires meeting members in the field (at their homes, Nursing Facilities, or other chosen locations) to assess their goals, needs, and barriers, and then connecting them with quality services to promote their ultimate well-being and drive person-centered health outcomes. This role provides specialized support for Members receiving Long Term Services and Support (LTSS), focusing on addressing health-related social needs (HRSNs), offering psychosocial support, and ensuring LTSS meets the member's service needs. It may involve supporting members in Nursing Facilities by building relationships with staff, advocating for member care (including access to behavioral health services), and assessing the member's desire and ability to return to the community. The Care Coach will contact members telephonically and face-to-face to establish goals, evaluate resources, develop care plans, and identify LTSS providers and community partnerships to best meet the needs and goals of the member and caregiver through person-centered thinking approaches. The role includes developing and modifying Individual Service Plans, involving applicable care team members, and supporting members through navigation of their LTSS and related environmental and social needs. It also involves utilizing available member information to prevent duplicative assessments and focusing on supporting members and/or caregivers through an interdisciplinary approach to access long-term services and support, social, housing, educational, and other services, regardless of funding sources. Recommendations for appropriate Home and Community-Based Services to enable member independence in the community will be made, and interactions with other payer sources, providers, and Interdisciplinary Care Teams will be facilitated. The role also includes educating members on maintaining Medicaid eligibility and assisting with the entry of annual Level of Care assessments into the state portal.

Requirements

• Must reside in the Central region of Virginia (Franklin City, Southampton, Sussex, Dinwiddie or surrounding counties)
• Bachelor's degree in health or human services field OR an active LPN license in the Commonwealth of Virginia without disciplinary action.
• Two (2) years of prior experience in health care and/or case management.
• One (1) one year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria (adults, pediatrics populations at risk for chronic medical conditions & high social needs).
• 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 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.
• 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 to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.
• 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.
• 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

• Nursing home diversion or long-term care case management experience.
• Experience with Medicare & Medicaid recipients.
• Experience with electronic case note documentation and documenting in multiple computer applications/systems.
• Experience working with complex health population.
• Experience with health promotion, coaching and wellness.
• Experience working with a Waiver Program.
• 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.

Responsibilities

• Assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state.
• Guide members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
• Meet 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.
• Connect members with quality services to promote their ultimate well-being and drive person centered health outcomes.
• 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.
• 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.
• Contact members telephonically and face-to-face to establish goals and priorities, evaluate resources, develop plans of care, and identify LTSS providers and community partnerships.
• Develop and modify Individual Service Plan and involve applicable members of the care team in care planning.
• Support members through navigation of their LTSS and related environmental and social needs.
• Utilize available information pertaining to member to prevent the need for administration of duplicative assessments.
• Focus 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.
• Make recommendations for appropriate Home and Community-Based Services to enable member's independence in the community.
• Facilitate interactions with other payer sources, providers, and Interdisciplinary Care Teams.
• Educate members in maintaining Medicaid eligibility.
• Assist with entry of annual Level of Care assessment into state portal.

Benefits

• medical
• dental
• 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: Entry Level