Field-Based Medicaid Care Navigator

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

Benefits offered by this job

Medical, dental, vision

401(k)

Paid time off

Mileage reimbursement

Job summary

Humana Inc. is seeking a Care Coordinator in Illinois to support Medicaid members within the MLTSS/LTSS programs.

You will assess needs, develop personalized care plans, and connect individuals and families with resources to improve health and well-being. The role requires visiting members in homes or facilities with 75-90% travel, coordinating services, monitoring plans, and ensuring progress toward outcomes.

Qualifications

• Bachelor's degree in social sciences, social work, human services, or related field.
• LPN licensed in Illinois with one year experience conducting assessments and formal service for the elderly.
• Licensed Professional Counselor (LPC) or Licensed Social Worker (LSW).
• Must reside in Illinois; 1+ years healthcare/case management; 1+ years with Medicare/Medicaid or related services; proficient with MS Word/Excel/Outlook and EMR systems.

Responsibilities

• Visit Medicaid members in homes, Assisted Living Facilities, LTSS, or other care settings; 75%-90% local travel.
• Assess care needs to ensure services in least restrictive settings.
• Identify and resolve barriers hindering care.
• Plan and implement interventions to meet care needs.
• Coordinate services and monitor the care management plan against member goals.
• Monitor patient care to ensure progress toward outcomes using assessments and conversations.
• Assess and evaluate enrollees via telephonic and face-to-face assessments and evaluations.
• Assist enrollees to remediate gaps in care and access.
• Assist enrollees with grievances and appeals.
• Provide information on MCO requirements, services, and benefits.
• Refer to community resources as needed.
• Guide members toward resources through coordination with payers, providers, and teams.

Skills

Healthcare experience

Education

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

LPN licensed in Illinois

Licensed Professional Counselor (LPC)

Licensed Social Worker (LSW)

Tools

Microsoft Word

Microsoft Excel

Outlook

Electronic Medical Records

Job description

Humana Inc. is seeking a Care Coordinator in Illinois to support Medicaid members within the MLTSS/LTSS programs.

You will assess needs, develop personalized care plans, and connect individuals and families with resources to improve health and well-being. The role requires visiting members in homes or facilities with 75-90% travel, coordinating services, monitoring plans, and ensuring progress toward outcomes.