Job Title: Care Manager Support Assistant

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 days to assist with any barriers to accessing services.

Key Responsibilities

• Verify eligibility for the ACD and monitor and support families for 180 days to assist with any barriers to accessing services.
• Provide education and initial registration into the ECHO registration portal for active duty family members.
• Assist with regional transfers and ensure the receiving Managed Care Support Contractor receives the appropriate paperwork.
• Process faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility and referrals.
• Identify ABA providers and research necessary resources to support the beneficiary.
• Assist beneficiaries with the eligibility process and support families to ensure enrollment into the ACD and overcome barriers to obtaining required paperwork.
• Assist with regional transfers in and out of the region and ensure required paperwork is indexed into the electronic records system.
• Ensure all paperwork and documentation is notated within the clinical management system.
• Support the ASN with care coordination efforts of assigned beneficiary caseloads, including managing incoming & outgoing communications to manage provider placement, researching time availability and beneficiary preferences that impact access to care, identifying available local resources based on beneficiary needs, addressing ECHO enrollment issues, identifying ABA providers, and other non-clinical beneficiary concerns.
• Provide education and referrals for initial outcome measure completion for a seamless start to ABA services.
• Interface with providers as necessary and appropriate for issue follow-up and resolution.
• Educate and register families of active-duty service members (who must be enrolled with EFMP) in the ECHO registration portal and begin the provisional period.
• Monitor ECHO faxes and provisional paperwork to facilitate the transition to permanent status.
• Ensure documentation is accurate and documented in all applicable systems.
• Communicate ECHO requirements to beneficiaries to ensure they provide necessary paperwork, preventing gaps in care.
• Communicate effectively with other departments to coordinate beneficiary needs, support ACD goals, and exhibit Humana’s values at all times.
• Perform any other duties as needed.

Required Qualifications

• U.S. Citizenship (required by Department of Defense contract).
• Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services).
• 3 years of experience working in a clinic, hospital case management, managed care/healthcare setting, including experience with providers, taking phone calls from patients/providers, handling referrals, and assisting with coordinating care for patients.
• Experience helping patients with eligibility.
• Work at Home Requirements:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps recommended.
  • Wireless, wired cable, or DSL connection suggested.
  • Satellite, cellular, and microwave connections may be used only if approved by leadership.

Preferred Qualifications

• Military healthcare service experience or working knowledge of the TRICARE ACD program.
• Healthcare professional with a minimum of a Bachelor’s degree in social work, psychology, or a related health discipline from an accredited university.
• Knowledge of Autism Spectrum Disorder, specifically Applied Behavior Analysis and other related therapies.

Company Information

Humana is committed to putting health first and fostering a caring community.