Field-Based Care Transition & LTSS Specialist

Humana; Sycamore (IL); Remote; USD 59,000 - 81,000; Full time

Job summary

Humana is seeking a Transition/Custodial Prevention Specialist to work with members in Illinois, creating personalized care plans and coordinating LTSS. You will meet members in their homes or NF facilities, assess goals and barriers, and connect them with community resources to promote independence and better health outcomes.

You will collaborate with care teams, navigate Medicaid eligibility, and support caregivers while traveling regionally to serve members in Kane and DeKalb counties and

Qualifications

• Must reside in the state of Illinois.
• Bachelor's degree in social sciences, social work, human services, or a related field.
• Two years of experience with Medicare/Medicaid recipients, long-term care services, HCBS, or managed care organizations.
• One+ year of experience with custodial and transitional care.
• Experience using electronic information applications/software including EMRs.
• Ability to travel regionally to meet face-to-face with members and family, partners, and care teams.

Responsibilities

• Provide specialized support for LTSS with focus on health-related social needs, psychosocial support, and ensuring LTSS meets service needs.
• Support members in nursing facilities by building relationships with facility staff, advocating for care, and assessing community return possibilities.
• Contact members to establish goals, evaluate resources, develop plans of care, and identify LTSS providers and partnerships.
• Focus on an interdisciplinary approach to accessing LTSS, social, housing, educational and other services regardless of funding sources.
• Develop and modify Individual Service Plans with the care team and involve applicable members.

Skills

Travel to meet members

Education

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

Tools

Electronic Medical Records (EMR)

Job description

Humana is seeking a Transition/Custodial Prevention Specialist to work with members in Illinois, creating personalized care plans and coordinating LTSS. You will meet members in their homes or NF facilities, assess goals and barriers, and connect them with community resources to promote independence and better health outcomes.

You will collaborate with care teams, navigate Medicaid eligibility, and support caregivers while traveling regionally to serve members in Kane and DeKalb counties and