Care Management Coordinator
CVS Health- Full Time
- Junior (1 to 2 years)
Candidates must possess a Bachelor’s degree in social sciences, social work, human services, or a related field, or be an Unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one year of experience in conducting comprehensive assessments and provision of formal services for the elderly, or be a Licensed Professional Counselor (LPC) or Licensed Social Worker (LSW). Furthermore, candidates must reside in Central IL counties in the State of Illinois, primarily in the Lincoln, Clinton, and Decatur areas, and have at least one year of experience in healthcare and/or case management, including one year of experience with Medicare & Medicaid recipients and/or long-term care and/or Home and Community based services and/or working with individuals in those settings.
The Care Coordinator will assess and evaluate member needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families towards and facilitating interaction with resources appropriate for the care and wellbeing of members. They will ensure members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being, 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, and guide members/families towards resources appropriate for their care. The Care Coordinator will also visit Medicaid members in their homes, Assisted Living Facilities, and/or Long-Term Care Facilities and other care settings, conducting 75-90% local travel, and utilize their skills to make an impact by continuously monitoring patient care through assessment, data, conversations with members, and active care planning.
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.