Humana Gold Plus Integrated is seeking Long-Term Services and Support (LTSS) Care Coordinators (Care Coach 1) in the state of Illinois to assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families towards and facilitate interaction with resources appropriate for the care and wellbeing of members.
The LTSS Care Coordinator (Care Coach 1) employs a variety of strategies, approaches, and techniques to manage a member's health issues. The LTSS Care Coordinator (Care Coach 1) understands 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.
Key Responsibilities
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Visits Medicaid members in their homes, Assisted Living Facilities (ALFs), and/or Long-Term Care Facilities and other care settings – 75-90% local travel (see Additional Information section).
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Ensure members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs.
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Identifies and resolves barriers that hinder effective care.
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Plans and implement interventions to meet care needs.
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Coordinates services, monitors, and evaluates the case management plan against the member's personal goals.
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Ensures the member progresses towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning.
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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.
Required Qualifications
The Care Coordinator (Care Coach 1) must meet one (1) of the following requirements:
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Bachelor's degree in social sciences, social work, human services, or a related field.
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An active, unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one (1) year of experience in conducting comprehensive assessments and provision of formal services to elderly individuals.
The Care Coordinator (Care Coach 1) must meet ALL of the following requirements:
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Applicants must reside in Cook or Kane County, IL, within one of the following ZIP codes, or within a 10-mile radius of these Zip Codes: 60004, 60005, 60008, 60010, 60016, 60018, 60025, 60026, 60043, 60053, 60056, 60062, 60067, 60070, 60074, 60076, 60077, 60090, 60091, 60107, 60169, 60173, 60192, 60193, 60194, 60195, 60201, 60202, 60203, 60656, 60714, 64646, 60093
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One (1) or more years of experience in health care and/or case management.
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One (1) or more years of experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services (HCBS), and/or managed care organizations.
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Ability to use a variety of electronic information applications/software programs including electronic medical records.
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Ability to travel in the region to meet face to face with members and/or their families, community partners and care teams.
Preferred Qualifications
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An active, unrestricted Licensed Professional Counselor (LPC) in Illinois.
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An active, unrestricted Licensed Social Worker (LSW) in Illinois.
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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. See "Additional Information" section for language assessment information.
Additional Information
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Workstyle: This is a Field position - Employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.
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Travel: 75 - 90% field-based interactions with members and/or their families, community partners and care teams. May need to attend occasional onsite meetings in Humana's Schaumburg, IL office.
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Mileage Reimbursement for Travel: Mileage reimbursement is provided for work-related travel from your home to your first work location of the day, between client or assignment locations during the workday and final work location back to home.
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Work Schedule: Monday - Friday; 8:00 AM - 5:00 PM Central Standard Time (CST), with flexibility available. Additional hours may be required based on business needs.
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Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
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.
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.
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$53,700 - $72,600 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
