[Remote] Certified Occupational Therapy Assistant (UM ) at Humana

Michigan, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Associate’s Degree in Occupational Therapy with current licensure as Occupational Therapy Assistant in the state of Michigan
At least 2 years working in Occupational Therapy
Experience working with Medicaid and/or Medicare Plans
Experience working with vulnerable populations and the assessment and provision of Long Term Services and Supports (LTSS)
Ability to manage multiple or competing priorities in a fast-paced environment
Ability to work independently under general instructions and with a team
Excellent written and verbal communication skills
Comprehensive knowledge of Microsoft Word, Outlook, and Excel
Health Plan experience
Previous experience in discharge planning and/or home health or rehabilitation
Bilingual (Spanish, Arabic, Chaldean Neo-Aramaic or other)
Ability to work from a dedicated space with ongoing interruptions to protect member PHI/HIPAA information
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required
Pay Range: $48,900 - $66,200 per year

Responsibilities

Support the policies and procedures ensuring best and most appropriate treatment, long-term services and supports authorizations with a focus on home modifications, vehicle modifications and durable medical equipment/assistive & adaptive equipment
Make decisions on moderately complex to complex issues
Provide support for the utilization management process, including coordination, documentation, and communication of long-term services and supports authorizations
Work with Medicaid and/or Medicare plans to determine eligibility and coverage for LTSS
Assess and provision of LTSS to vulnerable populations
Conduct discharge planning and/or home health or rehabilitation services
Collaborate with other healthcare professionals to ensure comprehensive care
Develop and maintain relationships with members, providers, and other stakeholders
Communicate effectively with members, providers, and other stakeholders through written and verbal communication
Manage multiple or competing priorities in a fast-paced environment
Work independently under general instructions and with a team
Use established guidelines/procedures to make informed decisions
Use Microsoft Word, Outlook, and Excel to document and communicate information
Participate in training and meetings to stay up-to-date on industry developments
Travel to Humana's offices for training or meetings may be required

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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