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Care Coach - Kentucky Medicaid

Company: Humana
Location: Huntington
Posted on: November 26, 2022

Job Description:

DescriptionThe Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Coach 1 work assignments are often straightforward and of moderate complexity.ResponsibilitiesThis position employs a variety of strategies, approaches and techniques to manage a member's health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.The Care Coach 1 assesses and evaluates member's needs and requirements in order to establish a member specific care plan and coordinates services.

  • Manages a caseload of obstetric members and families.
  • Ensures members are receiving services in the least restrictive setting in order to achieve and/or maintain optimal well-being by assessing their care needs.
  • Planning and implementing interventions to meet those needs.
  • Coordinating services, and monitoring and evaluating the case management plan against the member's personal goals.
  • Guides members/families towards resources appropriate for their care. Services are driven by facilitating interactions with other payer sources, providers, interdisciplinary teams and others involved in the member's care as appropriate and required by our comprehensive contract.
  • Potential visits to meet with Medicaid members in their homes, other care settings, and/or community events - local travel.Required Qualifications:Care Coaches shall meet one of the following qualifications:
    • Bachelor's degree in Social Work, Sociology, Psychology, or Public Health OR experienced Obstetrics/Women's Health, Mother/Bay Licensed Practical Nurse, LPN, licensed in the state of Kentucky without disciplinary action with at least 2 years of relevant experience.
    • All other levels of education must have a minimum of 2 years professional experience working as a Birth Worker.Care Coaches shall also meet all of the following Requirements:
      • Strong advocate for members at all levels of care.
      • Strong understanding and respect of all cultures and demographic diversity.
      • Strong written and verbal communication skills.
      • Intermediate or better working knowledge using MS Office Products; Microsoft Word, Excel and Outlook.Additional Requirements / AdherenceWorkstyle : Remote Work at HomePreferred Locations: Eastern, Southern, or Western KentuckyAlternate States: May consider cities that are in close proximity of the preferred Kentucky regionsl listed above - States include West Virginia, Tennessee, Indiana, and OhioTravel:
        • The department is not travling at this time, but there is opportunity in the future for local visits to meet with Medicaid members in their homes, other care settings, and/or community events - local travel.Schedule: The department provides opportunity for a flexible scheduleOption 1:
          • Monday through Friday 8:00 AM to 5:00 PM EasternOption 2:
            • 4 10 hour shifts Monday through Friday
            • 10 hour Shift must be scheduled between 7:00 AM and 5:30 PM Eastern
            • May select one of the following days off, Monday, Wednesday or Friday
            • Leader approval required following successful completion of trainingHumana Safety Driver Policy: If this role is This role is part of Humana's Driver safety program and therefore requires an individual to have:
              • a valid state driver's license,
              • access to reliable transportation,
              • and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.Work at Home Requirements:
                • Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
                • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
                • Satellite and Wireless Internet service is NOT allowed for this role.
                • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA informationTuberculosis (TB) Screening:
                  • This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.Preferred Qualifications:
                    • Experience working in Newborn and or NICU.
                    • Medication application (RFA) experience.
                    • Prior experience with Medicaid recipients.
                    • Prior care case management experience.
                    • Previous experience with electronic case note documentation and experience with documenting in multiple computer applications/systems.
                    • Experience with health promotion, coaching and wellness.
                    • Knowledge of community health and social service agencies and additional community resources.
                    • Case Management CertificationCovid Requirement Policy:Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. This position will require proof of Covid-19 vaccination upon offer acceptance during the background screening process and prior to the start date. Preferred Qualifications:
                      • Associate / Bachelor's Degree
                      • Strong preference for experience in member services and a call center environment specifically but not limited to Medicare & Medicaid recipients.
                      • Previous experience with electronic case-note documentation and experienced with documenting in multiple computer applications/systems.
                      • Knowledge of community health and social service agencies and additional community resources. Additional Information:Interview Format
                        • As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
                        • If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
                        • If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5- 10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.Scheduled Weekly Hours40Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Keywords: Humana, Huntington , Care Coach - Kentucky Medicaid, Other , Huntington, West Virginia

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