Care Coach - Stars Quality

Humana

4d • $53,700 - $72,600 • Remote

About The Position

The Care Coach evaluates member needs, coordinates care, and drives interventions that support improved health outcomes, member experience, and quality performance. You will collaborate closely with members, caregivers, providers, community organizations, and internal partners to identify and resolve barriers to care, close care gaps, and promote adherence to treatment plans across Humana's Medicare Advantage populations.

Requirements

• Associate degree in any field.
• At least two (2) years of direct adult patient care experience, such as long-term care, home- and community-based services, a hospital or facility setting, case management, or a managed care organization.
• Experience collaborating with members of a healthcare team.
• Strong computer proficiency and demonstrated ability to learn and navigate multiple software applications, including electronic medical records.
• Strong communication and interpersonal skills, with the ability to build rapport with members, providers, internal teams, and other stakeholders.
• Strong organizational skills and attention to detail.
• Intermediate proficiency with Microsoft Office applications and healthcare documentation systems.
• Ability to work independently, manage competing priorities, and adapt quickly in a fast-paced environment.

Nice To Haves

• Experience in a telephonic environment working with geriatric, vulnerable, and/or low-income populations.
• Experience supporting Medicare, Medicaid, Dual Eligible Special Needs Plans (D-SNP), Chronic Special Needs Plans (C-SNP), or other managed care populations.
• Experience supporting quality improvement or Stars-related initiatives.
• Experience conducting member outreach and engagement activities, up to and including screening for depression symptoms and other barriers of care.
• Knowledge of community resources and social determinants of health.
• Experience working in a remote environment.
• Experience motivating others to improve their health.

Responsibilities

• Engage members in Stars and quality initiatives, including Depression Screening and Follow-Up (DSF) and Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC), and other evolving member outreach that improve member outcomes, experience, and organizational performance.
• Demonstrate agility and adaptability by supporting multiple Stars programs, including DSF, FMC, and other quality improvement initiatives as member health needs evolve.
• Conduct proactive telephonic outreach to members, primarily through an autodialer and other approved communication channels.
• Review available data and complete structured assessments to identify clinical, financial, functional, and social needs.
• Educate members about preventive care and connect them with appropriate healthcare, community, and social support resources.
• Collaborate with care managers, providers, and multidisciplinary partners to resolve barriers, promote member independence, and support desired health outcomes.
• Document assessments, outreach, and outcomes accurately and timely in applicable systems.
• Follow all program, regulatory, compliance, and documentation requirements.
• Navigate multiple computer systems while providing member-focused support in a fast-paced, structured environment.
• Adapt communication and workflow priorities to support diverse populations, evolving campaigns, and changing business needs.

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: Mid Level
• Education Level: Associate degree