[Remote] Care Management Support Assistant at Humana

Kentucky, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

U.S. Citizenship
Interim approval for government security clearance (NBIS)
3 years experience in a clinic, hospital, case management, managed care/healthcare setting
Experience with patient eligibility
Military health care service experience or working knowledge of TRICARE ACD program (Preferred)
Bachelor’s degree in social work, psychology, or related health discipline (Preferred)
Knowledge of Autism Spectrum Disorder, Applied Behavior Analysis, and related therapies (Preferred)
Minimum download speed of 25 Mbps and upload speed of 10 Mbps

Responsibilities

Assist beneficiaries with eligibility process and enrollment into the ACD
Support families to overcome barriers to obtaining required paperwork
Assist with regional transfers and ensure required paperwork is indexed
Notate paperwork and documentation within the clinical management system
Coordinate care for assigned beneficiary caseloads
Manage incoming & outgoing communications to provide placement
Research time availability and beneficiary preferences
Identify available local resources based on beneficiary needs
Assist with ECHO enrollment issues, identification of ABA providers, and other non-clinical concerns
Provide education and referrals for initial outcome measure completion
Interface with providers for issue follow-up and resolution
Educate and register active-duty family members in the ECHO registration portal
Monitor ECHO faxes and provisional paperwork
Ensure documentation is accurate and documented in all applicable systems
Communicate ECHO requirements to beneficiaries
Communicate effectively with other departments to coordinate needs of beneficiaries
Exhibit Humana’s values at all times
Perform other duties as needed

Skills

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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