Field-Based LTSS Navigator & Custodial Care Advocate

Humana; Geneva (IL); On-site; USD 59,000 - 81,000; Full time

Job summary

Humana is seeking a Transition/Custodial Prevention Specialist to work with members in home or community settings, creating personalized care plans and coordinating LTSS services to promote independence and well‑being.

The role requires 75–90% field travel, collaboration with care teams, and helping members maintain Medicaid eligibility while navigating HCBS options. Illinois residency and a related bachelor's degree are needed.

Qualifications

• Two years of experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services (HCBS), or managed care organizations.
• One (1) or more years of professional experience working with members in custodial and transitional care.
• Experience using a variety of electronic information applications/software programs including electronic medical records.

Responsibilities

• Provide specialized support for members receiving Long Term Services and Support (LTSS), with a focus on addressing health-related social needs (HRSNs), providing psychosocial support, and ensuring LTSS meets the member's service needs.
• Support members residing in NFs by building relationships with facility staff, advocating for member care (including access to needed behavioral health services), and assessing the member's desire and ability to return to the community.
• Contact members telephonically and face-to-face to establish goals and priorities, evaluate resources, develop plans of care, and identify LTSS providers and community partnerships to provide a combination of services and supports that best address the needs and goals of members and caregivers through person centered thinking approaches.
• Focus on supporting members or caregivers utilizing an interdisciplinary approach in accessing long term services and support, social, housing, educational and other services, regardless of funding sources to meet their needs.
• Develop and modify Individual Service Plans 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 members to prevent the need for administration of duplicative assessments.
• Make recommendations for appropriate Home and Community-Based Services (HCBS) to enable member's independence in the community.
• Facilitate interactions with other payer sources, providers, and interdisciplinary care teams.
• Educate members in maintaining Medicaid eligibility.
• Assist with entry of annual Level of Care assessment into state portal.

Skills

Medicare/Medicaid experience

Field/home visits

Travel mobility

Education

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

Job description

Humana is seeking a Transition/Custodial Prevention Specialist to work with members in home or community settings, creating personalized care plans and coordinating LTSS services to promote independence and well‑being.

The role requires 75–90% field travel, collaboration with care teams, and helping members maintain Medicaid eligibility while navigating HCBS options. Illinois residency and a related bachelor's degree are needed.