Care Management Support Assistant

** Become a part of our caring community and help us put health first*
* Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members;

assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary.

** KEY

ACCOUNTABILITIES *
* + Assist beneficiaries with eligibility process and support the family to ensure enrollment into the ACD and overcome barriers to obtaining required paperwork.  Assist with regional transfers in and out of the region and ensure required paperwork is indexed into the electronic records system.  Ensure all paperwork and documentation is notated within the clinical management system.

+ Assist ASN with care coordination efforts of assigned beneficiary caseloads to include but not limited to managing incoming & out-going communications to manage provide placement; researching time availability and beneficiary preferences that will impact access to care; identifying available local resources based on beneficiary needs; ECHO enrollment issues, identification of ABA providers and other non-clinical beneficiary concerns. Includes education and referrals for initial outcome measure completion for seamless start to ABA services.  

Interface with providers as necessary and appropriate for issue follow-up and resolution.

+ Families who are dependents of active-duty service members must be enrolled with EFMP, and associate will educate and register them in the ECHO registration portal and begin the provisional period.  Assist in monitoring ECHO faxes and provisional paperwork to facilitate transition to permanent status. Ensure documentation is accurate and documented in all applicable systems. Be able to communicate ECHO requirements to beneficiaries to ensure they provide necessary paperwork so there are no gaps in care.

+ Communicates effectively with other departments to coordinate needs of beneficiaries, support the goals of the ACD and exhibits Humana's values at all times.  Any other duties as needed.

** Use your skills to make an impact*
* ** Required Qualifications*
* + Our Department of Defense contract requires U.S. Citizenship

+ Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)

+ HGB is not authorized to do work in Puerto Rico per our government contract.  We are not able to hire candidates that are currently living in Puerto Rico.

+ Bachelor's Degree.

+ Minimum 3 years of experience working in a clinic, hospital case management, managed care/ healthcare setting - working with providers, taking phone calls from patients/providers, handling referrals and assisting with coordinating care for patients.  Helping patients with eligibility.

+ Proficiency using MS Office Suite, Word, Excel, PowerPoint, Outlook, and ability to navigate through multiple systems and platforms, such as Teams, SharePoint,

+ Prior work history making and receiving calls from members and providers to coordinate care needs.

** Preferred Qualifications*
* + Military health care service experience or working knowledge of TRICARE ACD program.

+ Healthcare professional with a Bachelor's degree in social work, psychology, or related health discipline from an accredited university.

+ Knowledge of Autism Spectrum Disorder, specifically about Applied Behavior Analysis and other related therapies.

** Workstyle:
** Remote Work at Home

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* Location:

** Continental United States

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* Schedule:

** 9:00 AM - 5:30 PM Eastern Time Monday through Friday

** Travel:
** None

** 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

** SSN Alert
** Humana values your personal identity protection. Please be aware that applicants may be asked to provide their…