Senior Care Coordinator - Catchment 7B, 7C

Humana; United States; Presencial; USD 65.000 - 95.000; Jornada completa

Descripción de la vacante

Humana is seeking a Senior Care Coordinator to evaluate member needs and guide families toward appropriate resources for care and wellbeing. You will mentor team members, monitor care plans, and support audits and onboarding processes.

Responsibilities include documenting in the clinical system, coordinating services, and visiting Medicaid members in homes or care facilities; extensive local travel (75-90%) is required. A strong healthcare background is essential.

Formación

• Bachelor’s degree in social sciences or related field.
• Licensed or eligible licensure in healthcare (LPN, LPC, LSW).
• Experience with Medicare/Medicaid and long-term care settings recommended.

Responsabilidades

• Mentor and support team; provide coaching and training.
• Document in clinical system and generate daily reports.
• Monitor field visits and audit processes; assist onboarding.
• Coordinate services and evaluate care plans against member goals.
• Support field staff and escalate issues to management.

Conocimientos

Communication skills

Interpersonal skills

Microsoft Word

Excel

Outlook

Educación

Bachelor's degree in social sciences or related field

Unrestricted LPN license (Illinois)

Licensed Professional Counselor (LPC)

Licensed Social Worker (LSW)

Master's degree (preferred)

Herramientas

Electronic medical records

Descripción del empleo

Become a part of our caring community

Humana Gold Plus Integrated is seeking a Senior Care Coordinator to evaluate member's needs and requirements to achieve and maintain an optimal wellness state by guiding members/families toward resources appropriate for their care and wellbeing. The Senior Care Coordinator work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Care Coordinator (SCC) will provide support to their manager by precepting, coaching, and mentoring team members. The SCC will assist in providing guidance, support, and development of processes utilized by the team as well as create supports and maintain a positive work environment. They will provide field work support to the team as needed and will monitor field work visits completed by team members. They will elevate issues to their manager as needed and support team management as requested.

The Senior Care Coordinator Primary Roles & Responsibilities include:

• Provides coverage for Care Coordinator (CC) 1 and 2 and be able to document in the clinical system.
• Mentors and supports the team, as well as training initiatives.
• Provides daily reports to the Care Coordinators regarding outstanding cases and will review daily compliance dashboards.
• Supports audit initiatives and support any internal and external auditing processes for the team.
• Completes field work support and review reports.
• Supports new hire onboarding including but not limited to precepting and case audits.
• Coordinates services, monitors, and evaluates the case management plan against the member's personal goals.
• Ensures the patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning.
• Guides members/families towards resources appropriate for their care. Services are driven by facilitating interactions with other payer sources, providers, interdisciplinary teams, and others involved in the member's care as appropriate and required by our comprehensive contract.
• Visits Medicaid members in their homes, and/or Long-Term Care Facilities and other care settings - requires 75-90% local travel .

Use your skills to make an impact

Required Qualifications

The Senior Care Coordinator must meet one (1) of the following requirements:

• Bachelor's degree in social sciences, social work, human services, or a related field.
• Unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly.
• Licensed Professional Counselor (LPC).
• Licensed Social Worker (LSW).

The Senior Care Coordinator must meet all following requirements:

• Must reside in the State of Illinois.
• 2+ years of experience in health care and/or case management.
• 2+ years of experience with Medicare & Medicaid recipients and/or long-term care and/or Home and Community based services and/or working with managed care organizations.
• Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.
• Ability to use a variety of electronic information applications/software programs including electronic medical records.
• Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.

This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

Work at Home Requirements

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Preferred Qualifications

• Master's degree in social sciences, social work, human services, or a related field.
• CCM certification.
• Experience with health promotion, coaching, and wellness.
• Expertise of community health and social service agencies and additional community resources

Additional Information

• Workstyle/Travel: This is a Field position that requires 75 - 90% travel in the field to visit members.
• Work Schedule : Monday - Friday; 8am - 5pm CST but open to flexibl