Field LTSS & Community Care Navigator

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

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings

Job summary

Humana Inc. is seeking a Transition/Custodial Prevention Specialist to work with members in Illinois, helping develop care plans, coordinate LTSS, and empower independence.

You will meet members at home, NF facilities, or locations of their choice, and coordinate services through an interdisciplinary team. You will travel regionally to member homes, care partners, and community resources, advocating for access to behavioral health services and ensuring Medicaid eligibility.

Qualifications

• Must reside in Illinois.
• Bachelor's degree in social sciences, social work, human services, or a related field.
• Two years of experience with Medicare/Medicaid recipients, long-term care, HCBS, or managed care organizations.
• One or more years of experience with custodial and transitional care.
• Experience using electronic information applications/software, including electronic medical records.
• Ability to travel regionally to meet members and families.

Responsibilities

• Provide specialized LTSS support focusing on health-related social needs and ensuring LTSS meets service needs.
• Engage with facilities and care teams to advocate for member care and community reintegration.
• Contact members to establish goals, assess needs, and identify LTSS providers and partnerships.
• Develop and modify Individual Service Plans with the care team.
• Support navigation of LTSS and related environmental and social needs.
• Use available data to minimize duplicative assessments and improve outcomes.
• Recommend Home and Community-Based Services to promote independence.
• Facilitate interactions with payers, providers and care teams.
• Educate members to maintain Medicaid eligibility.
• Enter annual Level of Care assessments into state portals.

Skills

EMR proficiency

Travel readiness

Education

Bachelor's degree in social sciences or related field

Active IL professional license (LPC/LSW/RN)

Tools

EMR software

Job description

Humana Inc. is seeking a Transition/Custodial Prevention Specialist to work with members in Illinois, helping develop care plans, coordinate LTSS, and empower independence.

You will meet members at home, NF facilities, or locations of their choice, and coordinate services through an interdisciplinary team. You will travel regionally to member homes, care partners, and community resources, advocating for access to behavioral health services and ensuring Medicaid eligibility.