Remote Care Transition Specialist

Humana; Indiana (PA); Remote; USD 59,000 - 81,000; Full time

Job summary

Humana is seeking a Transition Coordinator (Care Coach 2) to evaluate member needs and guide families toward appropriate care resources. The role involves coordinating transitions across Indiana Medicaid programs and various care settings, with a focus on maintaining optimal wellness for members.

Responsibilities include planning, follow-up, and collaboration with care teams to ensure seamless communication, transfer of clinical information, and adherence to program requirements.

Qualifications

• Must have a bachelor's degree in health and human services or a related field.
• Minimum of 2 years of relevant experience.
• Strong written and verbal communication skills.
• Proficiency with Word, Excel and Outlook.
• This role requires patient-facing interactions and TB screening participation.

Responsibilities

• Coordinate initial and ongoing member transitions in Indiana Medicaid programs and care settings.
• Assist with transition planning and post-transition follow-up.
• Collaborate with Member Advocate Coordinator and other departments to ensure coordinated care and communication.
• Ensure transfer of prior authorizations, utilization data, and clinical information.
• Support transitions from custodial settings to home and community-based settings.
• Conduct telephonic and in-person meetings within the assigned region with stakeholders to prevent custodial placements when possible.
• Assess member needs to establish and coordinate a personalized care plan.
• Guide members toward resources and payer sources to meet care needs.

Skills

Microsoft Word

Microsoft Excel

Microsoft Outlook

Verbal and written communication

Detail oriented

Education

Bachelor's degree in health and human services field

Job description

Humana is seeking a Transition Coordinator (Care Coach 2) to evaluate member needs and guide families toward appropriate care resources. The role involves coordinating transitions across Indiana Medicaid programs and various care settings, with a focus on maintaining optimal wellness for members.

Responsibilities include planning, follow-up, and collaboration with care teams to ensure seamless communication, transfer of clinical information, and adherence to program requirements.