Care Coach - Stars Quality

The Care Coach evaluates member needs, coordinates care, and drives interventions that support improved health outcomes, member experience, and quality performance. You will collaborate closely with members, caregivers, providers, community organizations, and internal partners to identify and resolve barriers to care, close care gaps, and promote adherence to treatment plans across Humana's Medicare Advantage populations.

• Work Style: Work at Home
• Training: Mandatory for the first four weeks, 8:30 a.m.–5:00 p.m. ET.
• Work Schedule: Monday - Friday, 10:00 a.m.
  
  - 8:00 p.m. ET after training.
• Time off is not permitted during the first month of training. The first 90 days following training are critical to building a strong foundation; therefore, planned or unplanned time away should be minimized.

• You will engage members in Stars and quality initiatives, including Depression Screening and Follow-Up (DSF) and Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC), and other evolving member outreach that improve member outcomes, experience, and organizational performance.
• You will demonstrate agility and adaptability by supporting multiple Stars programs, including DSF, FMC, and other quality improvement initiatives as member health needs evolve.
• You will conduct proactive telephonic outreach to members, primarily through an autodialer and other approved communication channels.
• You will review available data and complete structured assessments to identify clinical, financial, functional, and social needs.
• You will educate members about preventive care and connect them with appropriate healthcare, community, and social support resources.
• You will collaborate with care managers, providers, and multidisciplinary partners to resolve barriers, promote member independence, and support desired health outcomes.
• You will document assessments, outreach, and outcomes accurately and timely in applicable systems.
• You will follow all program, regulatory, compliance, and documentation requirements.
• You will navigate multiple computer systems while providing member-focused support in a fast-paced, structured environment.
• You will adapt communication and workflow priorities to support diverse populations, evolving campaigns, and changing business needs.

• Associate degree in any field.
• At least two (2) years of direct adult patient care experience, such as long-term care, home- and community-based services, a hospital or facility setting, case management, or a managed care organization.
• Experience collaborating with members of a healthcare team.
• Strong computer proficiency and demonstrated ability to learn and navigate multiple software applications, including electronic medical records.

• Experience in a telephonic environment working with geriatric, vulnerable, and/or low-income populations.
• Experience supporting Medicare, Medicaid, Dual Eligible Special Needs Plans (D-SNP), Chronic Special Needs Plans (C-SNP), or other managed care populations.
• Experience supporting quality improvement or Stars-related initiatives.
• Experience conducting member outreach and engagement activities, up to and including screening for depression symptoms and other barriers of care.
• Knowledge of community resources and social determinants of health.
• Experience working in a remote environment.
• Experience motivating others to improve their health.

• Applicants who currently hold an RN, LPN, LVN, APRN, NP, LMSW, or LCSW license are not eligible for consideration for this position.
• Strong communication and interpersonal skills, with…