Field-Based Medicaid Care Navigator

Humana; Illinois; On-site; USD 54,000 - 73,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement plan

Paid time off

Job summary

Humana is seeking a Care Coordinator in Illinois to support Medicaid members within the MLTSS/LTSS programs. You will conduct in-home and facility visits, assess needs, and develop individualized care plans to connect members with necessary services and resources.

The role requires collaboration with care teams, familiarity with MCO requirements, and a drive to improve member health outcomes. Travel is 75–90% in the field; standard hours apply.

Qualifications

• Bachelor's degree in social sciences, social work, human services, or a related field.
• Unrestricted Licensed Practical Nurse (LPN) license 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.
• Assess member care needs and develop personalized care plans.
• 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 member goals.
• Ensure the patient is progressing towards outcomes by monitoring care and updating plans.
• Assist enrollee in addressing gaps in care and access.
• Assist enrollee with filing grievances and appeals.
• Provide information to enrollee related to MCO requirements, services, and benefits.
• Provide referrals to community resources.

Skills

Home visits

Care planning

Education

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

Tools

Microsoft Word

Excel

Outlook

Electronic Medical Records

Job description

Humana is seeking a Care Coordinator in Illinois to support Medicaid members within the MLTSS/LTSS programs. You will conduct in-home and facility visits, assess needs, and develop individualized care plans to connect members with necessary services and resources.

The role requires collaboration with care teams, familiarity with MCO requirements, and a drive to improve member health outcomes. Travel is 75–90% in the field; standard hours apply.