Functional Screener- Madison, WI

Humana • Madison, WI

10d • Remote

About The Position

Become a part of our caring community and help us put health first Humana/iCare is seeking a Long Term Care Functional Screener to join the growing team in the Family Care Partnership (FCP) program. The Long Term Care Functional Screener (LTCFS) is responsible for conducting WI Adult Long Term Care Functional Rescreens for re-determination of members functional program eligibility. The Screener is responsible for screening members within the iCare Family Care Partnership service areas, as well as participate in all iCare and WI State LTCFS required compliance and quality assurance activities. Share your talents and develop your skills all while doing your part to improve the lives of others. Essential Duties and Responsibilities: Coordinate appointments with members or legal representative to complete Annual and Enrollment redetermination of functional eligibility within member’s home; conduct rescreens due to member change in functional abilities for redetermination of eligibility as identified by Interdisciplinary Team (IDT). Utilize established methodology of the Wisconsin LTCFS process to collect member-centered data regarding functional abilities, health status and needs-based use of personal and professional supports and verify consistency of member specific data between functional assessment and member’s record to ensure members functional needs are accurately reflected. Collaborate with the IDT to ensure all assigned LTCFS rescreens are completed within the required time frame. Submit information collected during face-to face interview and collaborative verification into WI State internet-based program while maintaining compliance of state mandated timelines & appropriate professional utilization of LTCFS Instruction Manual. Effectively maintain updates of status to assigned members LTCFS rescreens on department spreadsheets to ensure adherence of State of WI and iCare LTCFS timeframes. Review Level of Care for iCare members including follow-up consultation with Grievance and Appeals or Enrollment/Eligibility/Fiscal staff. Provide appropriate notice of Member Rights, in accordance with contractual requirements, to members who experience a change in level of care that may impact the benefit package or overall program eligibility. Attend meetings and trainings as required to maintain & enhance knowledge of agency processes & the Long-Term Care Functional Screen. Maintain LTCFS certification via completion of WI biennial Continuing Skills Test. Use your skills to make an impact

Requirements

• Four-year bachelor’s degree in a Health or Human Services related field with one (1) year of experience working with at least one of the Family Care target populations OR be a Wisconsin licensed Registered Nurse with one (1) year of experience working with at least one of the Family Care target populations
• The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities
• Selected individual must meet requirements and successfully complete online screener certification training course(s) and become certified as a functional screener.
• Knowledge of Microsoft Office Word and Excel
• Exceptional verbal/written communication and interpersonal skills
• Ability to use a variety of electronic information applications/software programs
• 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.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

Nice To Haves

• Current WI Adult LTCFS Certification or previous WI Adult LTCFS Certification.
• Prior experience with Medicare & Medicaid recipients
• Previous experience with electronic case note documentation and experienced with documenting in multiple computer applications/systems
• Experience with health promotion, coaching and wellness
• Knowledge of community health and social service agencies and additional community resources

Responsibilities

• Coordinate appointments with members or legal representative to complete Annual and Enrollment redetermination of functional eligibility within member’s home; conduct rescreens due to member change in functional abilities for redetermination of eligibility as identified by Interdisciplinary Team (IDT).
• Utilize established methodology of the Wisconsin LTCFS process to collect member-centered data regarding functional abilities, health status and needs-based use of personal and professional supports and verify consistency of member specific data between functional assessment and member’s record to ensure members functional needs are accurately reflected.
• Collaborate with the IDT to ensure all assigned LTCFS rescreens are completed within the required time frame.
• Submit information collected during face-to face interview and collaborative verification into WI State internet-based program while maintaining compliance of state mandated timelines & appropriate professional utilization of LTCFS Instruction Manual.
• Effectively maintain updates of status to assigned members LTCFS rescreens on department spreadsheets to ensure adherence of State of WI and iCare LTCFS timeframes.
• Review Level of Care for iCare members including follow-up consultation with Grievance and Appeals or Enrollment/Eligibility/Fiscal staff.
• Provide appropriate notice of Member Rights, in accordance with contractual requirements, to members who experience a change in level of care that may impact the benefit package or overall program eligibility.
• Attend meetings and trainings as required to maintain & enhance knowledge of agency processes & the Long-Term Care Functional Screen.
• Maintain LTCFS certification via completion of WI biennial Continuing Skills Test.

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