Care Coordinator at Humana

Chicago, Illinois, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medicaid, Long-Term CareIndustries

Requirements

Must meet one (1) of the following: Bachelor’s degree in social sciences, social work, human services, or a related field; OR active, unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one (1) year of experience in conducting comprehensive assessments and provision of formal services to elderly individuals
Must meet ALL of the following: Reside in the south Chicago, IL area in zip code 60615, 60617, 60637, or 60649
One (1) or more years of experience in health care and/or case management
One (1) or more years of experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services (HCBS), and/or managed care organizations
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 communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders
Ability to travel in the region to meet face to face with members and/or their families, community partners, and care teams (75-90% local travel)
Part of Humana’s Tuberculosis (TB) screening program (patient facing role)
Valid state driver’s license and maintain personal vehicle liability insurance ($25,000 bodily injury per person/$25,000 bodily injury per event/$10,000 for property damage or state minimum, whichever is higher)

Responsibilities

Visit Medicaid members in their homes, Assisted Living Facilities (ALFs), Long-Term Care Facilities, and other care settings (75-90% local travel)
Assess and evaluate members’ needs and requirements to achieve and/or maintain optimal wellness state
Ensure members are receiving services in the least restrictive setting by assessing their 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 the member’s personal goals
Continuously monitor patient care through use of assessment, data, conversations with member, and active care planning to ensure progress towards desired outcomes
Guide members/families towards resources appropriate for their care
Facilitate interactions with other payer sources, providers, interdisciplinary teams, and others involved in the member’s care as appropriate and required by comprehensive contract
Employ a variety of strategies, approaches, and techniques to manage a member’s health issues

Skills

Care Coordination

Case Management

LTSS

Medicaid

Assessment

Care Planning

Patient Monitoring

Interdisciplinary Collaboration

Resource Navigation

Home Visits

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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