Care Coordinator

Humana • Peoria, IL

22h • Remote

About The Position

Humana Illinois is looking for Care Coordinators (Care Coach 1) to assess and evaluate members' needs and condition using standardized assessment tools during face-to-face visits or telephonic interactions with members. The Care Coordinator will work with members and the member's Interdisciplinary Care Team to achieve and/or maintain optimal wellness state by guiding members and families towards resources appropriate for the care and wellbeing of our Illinois members. The Care Coordinator employs a variety of strategies, approaches, and techniques to manage a member's health issues. The Care Coordinator understands their own work area, professional concepts/standards, regulations, strategies, and operating standards, and makes decisions regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

Requirements

• Bachelor's degree in social sciences, social work, human services, or a related field.
• An active, unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one (1) year of experience conducting comprehensive assessments and provision of formal services to elderly individuals.
• Applicants must reside in the state of Illinois or within a 10-mile radius of Illinois in a bordering state.
• One (1) or more years of experience in health care and/or case management.
• One (1) or more years of experience working with Medicare and Medicaid recipients, and/or managed care organizations.
• 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 communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
• Ability to travel in the region to meet face to face with members and/or their families, community partners and care teams.
• This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program.
• 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.
• Individuals 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

• An active, unrestricted Licensed Professional Counselor (LPC), Licensed Social Worker (LSW), or Licensed Practical Nurse (LPN) in Illinois.
• 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

• Visits Humana Illinois FIDE members in their homes or other local settings. 75 -90% local travel.
• Assesses and evaluates enrollee's needs by conducting telephonic and face to face assessments and evaluations, to coordinate services and address enrollee needs.
• Assists enrollees to remediate immediate and acute gaps in care and access.
• Assists enrollees with filing grievances and appeals.
• Provides information to enrollee related to MCO requirements, services, and benefits.
• Provides enrollee with information and/or referrals to community resources.
• Ensure members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs.
• Identifies and resolves barriers that hinder effective care.
• Plans and implement interventions to meet care needs.
• Coordinates services, monitors, and evaluates the case management plan against the member's personal goals.
• Ensures the member progresses towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with members, and active care planning.
• Guides members/families towards resources appropriate for their care.
• Services are driven by facilitating interactions with other payer sources, providers, interdisciplinary teams, and others involved in the member's care as appropriate and required by our comprehensive contract.

Benefits

• medical
• dental
• 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

What This Job Offers

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