Medicaid Care Navigator & Field Coordinator

Humana; Illinois; On-site; USD 54,000 - 73,000; Full time

Job summary

Humana is seeking a Care Coordinator to support Illinois HealthChoice Medicaid. You will be the first point of contact for newly enrolled members, conduct HRAs, identify needs, and connect members with services and resources, coordinating care in the early stages of their healthcare journey.

In this field role, you will travel to members’ homes or facilities (75% travel), assess barriers to care, plan interventions, and monitor progress toward outcomes.

Qualifications

• Bachelor's degree in social sciences, social work, human services, or related field.
• Unrestricted LPN in Illinois with 1 year experience conducting comprehensive assessments and provision of formal service for the elderly.
• Licensed Professional Counselor (LPC) or Licensed Social Worker (LSW).
• Must reside in Illinois and have 1+ years of experience in health care and/or case management.
• 1+ years of experience with Medicare & Medicaid recipients and/or long-term care and/or Home and Community based services and/or managed care organizations.
• Intermediate to advanced computer skills with Word, Excel, and Outlook; experience with EMR systems.

Responsibilities

• Visit Medicaid enrollees in their homes, Assisted Living Facilities, and Long-Term Care Facilities (75% local travel).
• Assess enrollee care needs and ensure services in the least restrictive setting.
• Identify and resolve barriers hindering care.
• Plan and implement interventions to meet care needs.
• Coordinate services, monitor and evaluate the case management plan against enrollee goals.
• Monitor progress toward outcomes via assessments, conversations, and care planning.
• Assess needs via telephonic and face-to-face evaluations to coordinate services.
• Assist with gaps in care and access; assist with grievances and appeals.
• Provide information on MCO requirements, services and benefits; referrals to community resources.

Education

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

Unrestricted Licensed Practical Nurse (LPN) in Illinois with one year experience

Licensed Professional Counselor (LPC)

Licensed Social Worker (LSW)

Tools

Microsoft Word

Excel

Outlook

Electronic Medical Records

Job description

Humana is seeking a Care Coordinator to support Illinois HealthChoice Medicaid. You will be the first point of contact for newly enrolled members, conduct HRAs, identify needs, and connect members with services and resources, coordinating care in the early stages of their healthcare journey.

In this field role, you will travel to members’ homes or facilities (75% travel), assess barriers to care, plan interventions, and monitor progress toward outcomes.