[Remote] BH Care Coach (Crisis Service Care Coordinator) at Humana

Virginia, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Bachelor’s degree in mental health, human services, or related field
Minimum one year of experience working with individuals with SMI/SUD/SDOH needs, preferably in a crisis or care coordination setting
Demonstrated knowledge of crisis service modalities, including Mobile Crisis Response, Community Stabilization, 23-Hour Crisis Services, and Residential Crisis Service Units
Strong communication, advocacy, and collaboration skills
Experience with electronic health record documentation and data management platforms
Ability to work independently and as part of an interdisciplinary team

Responsibilities

Provide timely telephonic outreach and active care coordination to members receiving Mobile Crisis Response, Community Stabilization, 23-Hour Crisis Services, and Residential Crisis Service Unit, or those who have high ED utilization
Ensure seamless transitions between levels of care, including step-downs from higher-intensity services and diversions from unnecessary inpatient admission
Engage natural supports and coordinate with community resources to address member needs and promote stabilization
Work collaboratively with provider agencies to verify transition appointments, support medication management needs, and facilitate warm handoffs to specialized programs
Assist in identifying recovery goals to help health plan members realize improved personal health outcomes through shared decision making and health literacy/education activities
Assess barriers to engagement, including noncompliance or lack of connection with lower levels of care, and support members through motivational interventions and advocacy
Participate in discharge planning with providers, members, and their support systems to ensure appropriate aftercare and reduce recidivism in crisis service utilization
Document all activities, appointments, and member contacts in the Care Management System in compliance with HIPAA regulations
Establish and maintain strong partnerships with community and advocacy organizations, including NAMI, Mental Health American Chapters, community-based, and peer run organizations
Communicate regularly with internal utilization management (UM) teams to address gaps in care and ensure authorizations for needed services
Participate in team meetings and rounds to review member and provider trends, collaborate on solutions, and maintain up-to-date knowledge of community resources and gold-star providers for step-down services
Build and leverage working relationships with providers and community programs to support member’s stability in the community

Skills

care coordination

crisis intervention

discharge planning

telephonic outreach

motivational interviewing

health literacy

recovery goal setting

community resources

medication management

behavioral health

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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