Patient Care Coordinator
CVS HealthFull Time
Entry Level & New Grad
Candidates must possess a Bachelor's degree in social sciences, social work, human services, or a related field, or an active, unrestricted Licensed Practical Nurse (LPN) license in Illinois with one year of experience assessing and providing services to the elderly. Applicants must reside in Illinois or within a 10-mile radius of Illinois in a bordering state. A minimum of one year of experience in healthcare and/or case management, and one year of experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services (HCBS), and/or managed care organizations is required. Intermediate to advanced computer skills, including proficiency in Microsoft Word, Excel, and Outlook, and the ability to use various electronic information applications/software programs, including electronic medical records, are necessary. Exceptional communication and interpersonal skills are essential, as is the ability to build rapport with diverse individuals. The role requires the ability to travel locally to meet face-to-face with members, community partners, and care teams, and candidates must be willing to undergo TB screening.
Care Coaches will assess and evaluate members' needs and requirements to achieve optimal wellness by guiding them towards and facilitating interaction with appropriate resources. This involves conducting telephonic and face-to-face assessments, coordinating services, and addressing immediate care gaps. Responsibilities include assisting enrollees with filing grievances and appeals, providing information on MCO requirements, services, and benefits, and referring them to community resources. Care Coaches will ensure members receive services in the least restrictive setting, identify and resolve barriers to effective care, and plan and implement interventions. They will coordinate services, monitor case management plans, and ensure member progress towards desired outcomes by continuously monitoring patient care. The role involves facilitating interactions with other payer sources, providers, and interdisciplinary teams.
Health insurance provider for seniors and military
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.