Field Care Navigator for LTSS & Community Supports

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

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Parental leave

Disability insurance

Life insurance

Job summary

Humana is seeking a Transition/Custodial Prevention Specialist in Illinois to work with members in homes, nursing facilities, or other sites to develop personalized care plans and connect them with LTSS and community resources.

You will meet members in the field, assess goals, and coordinate services with care teams to promote independence and better health outcomes. This field role requires extensive travel and collaboration with providers.

Qualifications

• Bachelor's degree in social sciences, social work, human services, or a related field.
• Two years of experience working with Medicare and Medicaid recipients, long-term care services, HCBS, or managed care organizations.
• One or more years of professional experience working with members in custodial and transitional care.
• Experience using electronic information applications including electronic medical records.
• Ability to travel in the region to meet face-to-face with members and/or their families, community partners and care teams.

Responsibilities

• Provide specialized support for members receiving 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

Travel in region

Medicare/Medicaid experience

Interdisciplinary collaboration

Field/home visits

Education

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

Tools

Electronic medical records

Job description

Humana is seeking a Transition/Custodial Prevention Specialist in Illinois to work with members in homes, nursing facilities, or other sites to develop personalized care plans and connect them with LTSS and community resources.

You will meet members in the field, assess goals, and coordinate services with care teams to promote independence and better health outcomes. This field role requires extensive travel and collaboration with providers.