Medicaid Care Navigator – Field-Based Impact

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

Job summary

Humana is seeking a Care Coordinator to support Illinois HealthChoice Medicaid Managed Care. You will assess members, develop care plans, and connect families with needed resources to improve health and wellbeing.

Responsibilities include home visits, care coordination, and addressing enrollee needs through assessments and referrals. This is a field role with extensive travel and flexible hours. HIPAA-compliant practices are required.

Qualifications

• Bachelor's degree in social sciences, social work, human services, or related field.
• Unrestricted LPN in Illinois with 1 year of elder assessments.
• Licensed Professional Counselor (LPC).
• Licensed Social Worker (LSW).

Responsibilities

• Visit Medicaid members in homes, facilities, and other settings; 75%-90% travel.
• Assess care needs to ensure services in least restrictive settings.
• Identify and resolve barriers to effective care.
• Plan and implement interventions to meet care needs.
• Coordinate services and monitor the care plan against goals.
• Ensure patients progress toward outcomes via assessments and care planning.
• Assess enrollee needs by telephonic and in-person evaluations.
• Remediate gaps in care and assist with grievances/appeals.
• Provide information on MCO requirements, services, and benefits.
• Refer enrollees to community resources.

Skills

Bachelor's degree in social sciences

LPN Illinois

LPC

LSW

Education

Bachelor's degree in social sciences or related field

Tools

Microsoft Word

Excel

Outlook

Job description

Humana is seeking a Care Coordinator to support Illinois HealthChoice Medicaid Managed Care. You will assess members, develop care plans, and connect families with needed resources to improve health and wellbeing.

Responsibilities include home visits, care coordination, and addressing enrollee needs through assessments and referrals. This is a field role with extensive travel and flexible hours. HIPAA-compliant practices are required.