Field-Based Medicaid Care Navigator

Humana Inc; Northfield Township (IL); On-site; USD 54,000 - 73,000; Full time

Job summary

Humana Inc. in Illinois seeks a Care Coordinator to support Medicaid Members by assessing needs, developing personalized care plans, and connecting individuals and families with community resources. You will report to the Manager, Care Management and work across LTSS/MLTSS assignments as needed.

The role requires 75-90% travel, field visits to member homes or care facilities, and coordination of services to achieve desired outcomes, with a Monday–Friday schedule and a pay range noted below.

Qualifications

• The Care Coordinator must meet one of the following requirements: Bachelor's degree in social sciences, social work, human services, or a related field.
• Unrestricted LPN in Illinois with one year of 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 with 75%-90% local travel.
• Ensure members are receiving services in the least restrictive setting to achieve and maintain well-being by assessing 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 member goals.
• Monitor patient care to ensure progress toward outcomes via assessments, conversations, and care planning.
• Assess and evaluate enrollees' needs via telephonic and face-to-face assessments and evaluations to coordinate services and address needs.
• Assist enrollees to remediate immediate and acute gaps in care and access.
• Assist enrollees with filing grievances and appeals.
• Provide information to enrollees related to MCO requirements, services, and benefits.
• Provide enrollee with referrals to community resources.
• Guide members/families toward resources and facilitate interactions with providers, payer sources, and interdisciplinary teams as required.

Skills

Bachelor's degree in social sciences

Unrestricted LPN (Illinois)

Licensed Professional Counselor (LPC)

Licensed Social Worker (LSW)

Education

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

Tools

Microsoft Word

Excel

Outlook

EMR systems

Job description

Humana Inc. in Illinois seeks a Care Coordinator to support Medicaid Members by assessing needs, developing personalized care plans, and connecting individuals and families with community resources. You will report to the Manager, Care Management and work across LTSS/MLTSS assignments as needed.

The role requires 75-90% travel, field visits to member homes or care facilities, and coordination of services to achieve desired outcomes, with a Monday–Friday schedule and a pay range noted below.