Field-Based Care Coordinator – Medicaid & Community Support

Humana; Orland Park (IL); Remote; USD 54,000 - 73,000; Full time

Job summary

Humana is seeking a Care Coordinator to support Illinois Medicaid Members within Humana Gold Plus Integrated. You will assess needs, develop personalized care plans, and connect families with resources to help them thrive.

This field position requires travel to member homes and care facilities, with a Monday–Friday schedule and 40 hours per week. You will work under the Manager, Care Management to ensure members receive appropriate services, address barriers, and coordinate with providers and

Qualifications

• Bachelor's degree in social sciences, social work, human services, or a related field.
• Unrestricted Licensed Practical Nurse (LPN) in Illinois with one year experience conducting comprehensive assessments and provision of formal service for the elderly.
• Licensed Professional Counselor (LPC).
• Licensed Social Worker (LSW).

Responsibilities

• Visit Medicaid members in their homes, Assisted Living Facilities, and/or Long-Term Care Facilities and other care settings – 75%-90% local travel.
• Ensure members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs.
• Identify and resolve barriers that hinder effective care.
• Plan and implement interventions to meet care needs.
• Coordinate services, monitor, and evaluate the case management plan against the member's personal goals.
• Ensure the patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with members, and active care planning.
• Assess and evaluate enrollee's needs via telephonic and face to face assessments and evaluations, to coordinate services and address enrollee needs.
• Assist enrollee to remediate immediate and acute gaps in care and access.
• Assist enrollee with filing grievances and appeals.
• Provide information to enrollee related to MCO requirements, services, and benefits.
• Provide enrollee with information and/or referrals to community resources.
• Guide 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.

Education

Bachelor's degree in social sciences, social work, human services, or a related field

Unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one (1) year experience conducting comprehensive assessments and provision of formal service for the elderly

Licensed Professional Counselor (LPC)

Licensed Social Worker (LSW)

Job description

Humana is seeking a Care Coordinator to support Illinois Medicaid Members within Humana Gold Plus Integrated. You will assess needs, develop personalized care plans, and connect families with resources to help them thrive.

This field position requires travel to member homes and care facilities, with a Monday–Friday schedule and 40 hours per week. You will work under the Manager, Care Management to ensure members receive appropriate services, address barriers, and coordinate with providers and