Care Coach

Humana; United States; On-site; USD 60,000 - 90,000; Full time

Job summary

Humana seeks a Service Coordinator (Care Coach 1) to assess member needs and coordinate LTSS, guiding families to appropriate resources for wellbeing and outcomes. Roles include in-person and telephonic outreach, plan development, and collaboration with care teams.

Responsibilities cover ongoing assessments, goal setting, referrals to LTSS providers, and ensuring integrated support across medical and community services for optimal wellness.

Qualifications

• Prior experiences in health care and/or case management.
• Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.
• Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
• Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills.
• Ability to manage multiple or competing priorities in a fast-paced environment.
• Ability to use a variety of electronic information applications/software programs including electronic medical records.

Responsibilities

• Administer initial and ongoing LTSS related assessments through person-centered thinking approaches.
• Contacts members telephonically and/or in-person to establish goals and priorities, evaluate resources, develop plan of care and identify LTSS providers and community partnerships.
• Development and continuous modification of 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.
• Focuses on supporting members and/or caregivers in accessing long term services and supports, social, housing, educational and other services.
• Build trust and promote independence through a collaborative relationship with the Care Coordinator, member and caregiver.
• Identify transition opportunities and work with transition coordinators to support member choice.
• Coordinating with Care Coordinator on referrals for non-capitated services and capturing all services the member is receiving.
• Coordinating and consulting with Humana-contracted providers regarding LTSS delivery.
• Participates in interdisciplinary Care team meetings (ICT).
• Connecting and referring members to community resources and third-party payers.
• Assisting members in maintaining Medicaid eligibility.
• Collaborate with Medical Director/Geriatrician/Care Coordinator to ensure cohesive service delivery.

Skills

Communication

Interpersonal skills

Critical thinking

Organization

Problem solving

Multitasking

Education

RN/LPN or related nursing degree

Bachelor’s degree in Social Work, Psychology, Counseling, Gerontology, Nursing or Health & Human Services (with 2+ years experience)

Bachelor’s degree in any field with 2+ years direct service experience (older adults or disabilities)

Master’s degree in Social Work, Psychology, Counseling, Gerontology, Nursing or Health & Human Services (with 2+ years experience)

Tools

Microsoft Word

Excel

Outlook

Electronic Medical Records

Job description

Become a part of our caring community

The Care Coach evaluates member's needs to achieve or maintain wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Coach 1 work assignments are often straightforward and of moderate complexity.

The Service Coordinator (Care Coach 1) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Service Coordinator work assignments are often straightforward and of moderate complexity.

The Service Coordinator (Care Coach 1) role involves meeting members in their location, spending quality time assessing their needs and barriers and then connecting our members with quality services to promote their ultimate well-being and drive health outcomes. Responsibilities include:

• Administer initial and ongoing long-term services and support (LTSS) related assessments through person-centered thinking approaches
• Contacts members both telephonically and/or in-person to establish goals and priorities, evaluate resources, develop plan of care and identify LTSS providers and community partnerships to provide a combination of services and supports that best meet the needs and goals of member and caregiver through person centered thinking approaches.
• Development and continuous modification of Service Plan and involve applicable members of the care team in care planning (Informal caregiver coach, PCP, etc.)
• 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.
• Focuses on supporting members and/or caregivers in accessing long term services and support, social, housing, educational and other services, regardless of funding sources to meet their needs.
• Build trust and promote independence through a collaborative relationship with the Care Coordinator, member and caregiver.
• Identify transition opportunities and work closely with transition coordinators to support member choice.
• Coordinating with Care Coordinator on referrals for non-capitated services and capturing all services the member is receiving (regardless of payer), including their natural supports.
• Coordinating and consulting with Humana-contracted providers regarding delivery of LTSS services
• Participates in interdisciplinary Care team meetings (ICT)
• Connecting and referring members to community resources and third-party payers
• Assisting members in maintaining Medicaid eligibility
• Collaborate with Medical Director/Geriatrician/Care Coordinator as deemed necessary to ensure cohesive, holistic service delivery and support positive member outcomes.

Use your skills to make an impact

Required Qualifications

Service Coordinators (Care Coach 1) shall meet one of the following qualifications:

• Individual continuously employed as a care manager by an AAA since June 30, 2018; OR
• Registered nurse, a licensed practical nurse, or an associate's degree in nursing with at least one (1) year of experience serving the program population; OR
• Bachelor's degree in Social Work, Psychology, Counseling, Gerontology, Nursing or Health & Human Services with at least (2) years of experience; OR
• Bachelor's degree in any field with a minimum of two (2) years full-time, direct service experience with older adults or persons with disabilities (this experience includes assessment, care plan development, and monitoring); OR
• Master's degree in Social Work, Psychology, Counseling, Gerontology, Nursing or Health & Human Services with at least (2) years of experience; OR
• Associate's degree in any field with a minimum of four (4) years full-time, direct service experience with older adults or persons with disabilities (this experience includes assessment, care plan development, and monitoring).

Must meet all following requirements:

• Prior experiences in health care and/or case management.
• Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.
• Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
• Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills.
• Ability to manage multiple or competing priorities in a fast-paced environment.
• Ability to use a variety of electronic information applications/software programs including electronic medical records.

Preferred Qualifications

• Bilingual (English/Spanish)
• Bilingual (English/Burmese)
• Prior nursing home diversion or long-term care case management experience
• Prior experience with Medicare & Medicaid recipients
• Experience with electronic case note documentation and documenting in multiple computer applications/systems.

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