Care Coordinator

Quick Facts

• Role: Care Coordinator (Field position)
• Program: Illinois HealthChoice Medicaid Managed Care
• Reporting to: Manager, Care Management
• Travel: 75%–90% local travel; visits to homes, assisted living facilities, and/or long-term care facilities
• Schedule: Monday–Friday 8am–5pm CST; flexible schedule; possible additional hours
• Assignment: MLTSS or LTSS based on business needs

Description

Join as a Care Coordinator to assess members’ unique needs, develop personalized care plans, and connect individuals and families with resources and support to improve health and well-being.

Responsibilities

• Visit Medicaid members in their homes, Assisted Living Facilities, Long-Term Care Facilities, and other care settings (75%–90% local travel)
• Ensure members receive services in the least restrictive setting by assessing care needs
• Identify and resolve barriers that hinder effective care
• Plan and implement interventions to meet care needs
• Coordinate services, monitor, and evaluate the case management plan against members’ personal goals
• Continuously monitor patient care using assessment, data, conversations, and active care planning to ensure desired outcomes
• Assess and evaluate enrollee needs via telephonic and face-to-face assessments and evaluations
• Assist enrollees to remediate immediate and acute gaps in care and access
• Assist enrollees with filing grievances and appeals
• Provide information to enrollees related to MCO requirements, services, and benefits
• Provide information and/or referrals to community resources
• Guide members/families toward appropriate resources; facilitate interactions with payer sources, providers, interdisciplinary teams, and others per contract requirements

Requirements

Must meet one of the following:

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

Must also meet all following requirements:

• Reside in Illinois
• 1+ years of experience in health care and/or case management
• 1+ 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; experience with Microsoft Word, Excel, and Outlook
• Experience using a variety of electronic information applications/software programs including electronic medical records

Additional Information

• Driving: Valid state driver’s license required; maintain personal vehicle liability insurance meeting state minimums (or $25,000 bodily injury per person/$25,000 bodily injury per event/$10,000 property damage, whichever is higher)
• TB: TB screening required if selected
• Work at Home requirements: internet must meet at least 25 Mbps download and 10 Mbps upload; dedicated space to protect member PHI/HIPAA; Humana may require upgrades if needed
• Travel: Occasional travel to Humana offices for training/meetings may be required
• Scheduled Weekly Hours: 40
• Pay Range: $53,700 - $72,600 per year

Description of Benefits

Humana offers medical, dental, and vision benefits; 401(k) retirement savings plan; time off including paid time off and holidays; paid parental and caregiver leave; short-term and long-term disability; life insurance; and many other opportunities.