Community Management Professional 1 - Humana Healthy Horizons in Kentucky

Employment Type: Full-time

Position Overview

Humana Healthy Horizons in Kentucky is seeking a Community Management Professional 1 to join our team in the Lexington, Kentucky, and surrounding areas. This role actively engages with members to address their health-related social needs. Join a dedicated team and lead change in how healthcare for the underserved in Kentucky is managed. Share your talents, develop your skills, and make a difference in the lives of others.

Essential Role Functions and Responsibilities

• Conduct in-person and telephonic non-clinical assessments to understand enrollee care needs, preferences, and socioeconomic barriers, evaluating the home environment as needed in Lexington, Kentucky, and surrounding areas.
• Collaborate 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.
• 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, arranging 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 who miss appointments to understand the reasons and problem-solve barriers to care.
• Monitor enrollee compliance with their care plan and provide motivational interviewing to support medication and treatment adherence.
• Provide social support to 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 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.

Required Qualifications

Must meet one of the following:

• Associate's degree and five (5) years of experience working with members face-to-face and telephonically conducting assessments, and/or professional experience in human services or as a community health worker.
• Bachelor's degree or higher and three (3) years of experience working with members face-to-face and telephonically conducting assessments, and/or professional experience in human services or as a community health worker.

Must meet all of the following:

• Certified Community Health Worker in the state of Kentucky or willingness to obtain certification within 12 months of hire.
• 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).

Workstyle and Location

• Workstyle: Combination remote work at home and field-based.
• Location: Must reside within a 30-mile radius of Lexington, Kentucky.

Schedule

• Must be able to work Monday-Friday between the hours of 8:00 AM to 6:00 PM Eastern Time.
• Must maintain flexibility to work weekday evenings based on business needs.

Travel

• Travel is required within the specified service area.