Community Management Professional 1 - Humana Healthy Horizons in Kentucky

Employment Type: Full-time

Location Type: Combination remote work at home and field based

Location: Must reside in the state of Kentucky or Southern Indiana within 15 minutes of Kentucky border

Schedule: Must be able to work Mon-Fri between the hours of 8:00 AM to 6:00 PM Eastern Time and maintain flexibility to work weekday evenings based on business needs.

Travel: 60-75% typically Monday through Friday, with opportunity to participate in events on the weekends, but is not required.

Position Overview

Become a part of our caring community and help us put health first. Humana Healthy Horizons in Kentucky is seeking a Community Management Professional 1 to join our team. This associate actively engages with members to help address their health-related social needs. Join this amazing and dedicated team and lead change in how health care for the underserved in Kentucky is managed. Share your talents and develop your skills all while doing your part to make a difference in the lives of others.

Essential Role Functions and Responsibilities

• Conduct in-person and telephonic non-clinical assessment(s) to understand enrollee care needs, preferences, and socioeconomic barriers and evaluate the home environment as needed.
• Work collaboratively with other Humana associates as a member of Humana’s Care Management Support teams, including case managers, SDOH coordinators, Community Education Representatives (CER), and the Quality Improvement team that conducts HEDIS outreach.
• Serve as a member of enrollee multi-disciplinary care teams (MDT), as requested.
• Assist enrollees with scheduling physical health and behavioral health (BH) office visits and addressing barriers to appointment attendance.
• Assess enrollee barriers to healthy living and accessing healthcare services and arrange needed social services and supports.
• Act as an enrollee advocate with providers, community resources, schools, and others, including accompanying enrollees to provider office visits as requested.
• Locate enrollees when they miss appointments to find out why the appointment was missed and problem-solve to address barriers to care.
• Monitor enrollee compliance with their care plan and provide motivational interviewing to support medication and treatment adherence.
• Provide social support to help boost enrollees’ morale and sense of self-worth, serving as a trustworthy, reliable, non-judgmental, consistent, and accepting member of the enrollee’s MDT.
• Support enrollee self-management through the provision of culturally appropriate health education and health coaching.
• Serve as a key knowledge source for community services and information for enrollees and other Humana associates.
• Attend Humana community events to connect with enrollees and provide education on case management services.
• Conduct research and in-person outreach to locate difficult-to-contact enrollees to increase assessment completion and participation in clinical programs.
• Build and maintain relationships with providers and community resources to support enrollee identification and referrals.
• Implement community assessments to identify community resource gaps.
• Use your skills to make an impact.

Required Qualifications

• Bachelor's degree
• Certified Community Health Worker in the state of Kentucky or willingness to obtain certification within 12 months of hire.
• Minimum 3 years of experience working with members face to face conducting assessments
• Minimum 3 years of professional human services and/or community health worker experience
• Proficient in Microsoft Office (Excel, Word)
• Ability to use a variety of electronic information applications/software programs

Preferred Qualifications

• Prior experience with Medicaid recipients
• Bilingual skills - Language assessment is required to be considered fluent

Tuberculosis (TB) Screening Program

This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.