Care Coach; Adults and Pediatrics

Overview

Become a part of our caring community and help us put health first

Humana Healthy Horizons in Virginia is looking for Care Coaches who will assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and wellbeing of members. The Care Coach work assignments are often straightforward and of moderate complexity.

• Manages a caseload of members.
• Develops and modifies Individual Care Plan and involves applicable members of the care team in care planning (informal caregiver, coach, PCP, etc.).
• Provides specialized support for members with a focus on addressing health related social needs (HRSNs), providing psychosocial support, and meeting the member's individualized health needs.
• Ensures members are receiving services in the least restrictive setting in order to achieve and/or maintain optimal well-being by assessing their care needs.
• Focuses on supporting members and/or caregivers utilizing an interdisciplinary approach in accessing social, housing, educational and other services, regardless of funding sources to meet their needs.
• Ensures members are progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning.
• Collaborates with Community Health Workers (CHWs), Housing Specialists and other internal and external agencies for HRSN needs.
• Primary point of contact for the ICT and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member's needs are met.
• Employs a variety of strategies, approaches and techniques to manage a member's health issues and identify and resolve barriers that hinder effective care.
• Understands professional concepts, regulations, strategies and operating standards.
• Makes decisions regarding work approach/priorities and follows direction.

• Must reside in Virginia (NOVA region)
• Bachelor's degree in health or human services field or an active LPN license in the Commonwealth of Virginia without disciplinary action.
• Two (2) years of prior experience in health care and/or case management.
• One (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria (adults, pediatrics populations at risk for chronic medical conditions & high social needs).
• Strong advocate and respect for members at all levels of care.
• 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 oral and written communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
• Ability to manage multiple or competing priorities in a fast-paced environment.
• This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• Ability to travel to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.
• 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 maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

• Prior experience with Medicare, Medicaid and dual eligible populations.
• Experience with health promotion, coaching and wellness.
• Knowledge of community health and social service agencies and additional community resources.
• Case Management Certification (CCM).
• Bilingual or Multilingual:
  English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and…