Care Coach

Become a part of our caring community Are you passionate about improving access to care and helping people live healthier lives? Join Humana's IL Health Choice Medicaid team as a Care Coach, where you'll build meaningful connections with members and guide them through their healthcare journey. Using a whole-person approach, you'll assess needs, coordinate services, and connect members with valuable resources that support their health, independence, and overall well-being.

• Perform member outreach to screen members for risk stratification and ensure compliance with outreach and contact requirements.
• Identify triggers for referral into care management, chronic condition disease management, and other care management and/or specialty programs.
• Screen members using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
• Employ a variety of strategies, approaches and techniques to manage a member’s health issues including identifying and resolving barriers that hinder effective care.
• Promote communication, both internally and externally, to enhance effectiveness of care management services (e.g. providers, and health care team members respectively).
• Ensure members progress towards desired outcomes by continuously monitoring member care through use of assessment, data, and conversations with members, and active care planning.
• Participate in a multi-disciplinary team including internal and external participants.
• Adhere to compliance with policies and procedure/regulatory standards.
• Maintain accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protect the confidentiality of member information and adheres to company policies regarding confidentiality.
• Demonstrate ability to meet daily metrics with speed, accuracy, and a positive attitude.
• Complete documentation of member calls in the electronic record, thoroughly completing required actions with a high level of detail to ensure compliance requirements are met with efficiency.

The 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.
• Licensed Professional Counselor (LPC) Licensed Social Worker (LSW).

The Care Coordinator must meet all following requirements:

• Must reside in Illinois or a border state within a commutable distance of IL.
• 1+ years of experience in health care and/or case management.
• 1+ years of experience with Medicare & Medicaid recipients and/or working with managed care organizations.

• Bilingual English
  - Spanish/Polish/Arabic/Creole
• Certified Case Manager (CCM)
• Master's degree in health service-related field
• Prior experience with Medicare & Medicaid recipients
• Previous experience with electronic case notes documentation and experienced with documenting in multiple computer applications/systems
• Experience with health promotion, coaching and wellness
• Knowledge of community health and social service agencies and additional community resources
• Experience with case management, discharge planning and patient education for adult acute care
• Familiarity with basic medical terminology and concepts used in care management preferred.

• Workstyle:
  This is a remote position that requires travel.
• Travel:
  Up to 25% field-based interactions meeting with members and/or their families, community partners and other care teams. May need to attend occasional onsite meetings in Humana's Illinois locations.
• Typical Workdays and
  
  Hours:
  
  Operating hours are Monday
  - Friday 8:00 AM - 7:00 PM CST but core hours for this position are primarily Monday
  - Friday, 8:00 AM - 5:00 PM CST. May need to be flexible with work schedule based on business needs.
• Driving:
  This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to…