Care Coach – Stars Quality

This is a fully remote position, open to applicants in United States.

📋 Description

• Assess member needs and coordinate their care effectively.

• Implement interventions that enhance health outcomes, member experience, and quality performance.

• Collaborate with members, caregivers, healthcare providers, community organizations, and internal teams.

• Identify and address obstacles to care.

• Close care gaps and encourage adherence to treatment plans within Humana's Medicare Advantage populations.

• Involve members in Stars and quality initiatives, including Depression Screening and Follow-Up (DSF) and Follow-Up After Emergency Department Visit for Individuals with Multiple High-Risk Chronic Conditions (FMC).

• Support various Stars programs and ongoing quality improvement initiatives.

• Conduct proactive telephonic outreach utilizing an autodialer and approved communication methods.

• Analyze data and perform structured assessments of clinical, financial, functional, and social needs.

• Educate members about preventive care options.

• Connect members to healthcare, community, and social support resources.

• Work in partnership with care managers, providers, and multidisciplinary teams.

• Accurately and promptly document assessments, outreach, and outcomes.

• Adhere to program, regulatory, compliance, and documentation requirements.

• Navigate various computer systems in a fast-paced, structured environment.

• Adjust communication and workflow priorities to meet the needs of diverse populations and changing business demands.

⛳️ Requirements

• An associate degree in any field is required.

• A minimum of two (2) years of direct adult patient care experience, including long-term care, home and community-based services, hospital or facility settings, case management, or managed care organizations.

• Experience in collaborating with a healthcare team.

• Proficiency in computer usage is essential.

• Capability to learn and navigate multiple software applications, such as electronic medical records.

• Applicants with current RN, LPN, LVN, APRN, NP, LMSW, or LCSW licenses are not eligible for consideration.

• Strong communication and interpersonal abilities are necessary.

• Excellent organizational skills and attention to detail are required.

• Intermediate proficiency with Microsoft Office applications and healthcare documentation systems.

• Ability to work independently, prioritize competing demands, and adapt quickly in a fast-paced setting.

• Must have self-provided internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• Capability to work from a dedicated space without ongoing interruptions to ensure the protection of member PHI/HIPAA information.

• Florida applicants working from a home-based location in Florida are subject to Florida Level 2 background screening.

• Preferred: Experience in a telephonic environment serving geriatric, vulnerable, and/or low-income populations.

• Preferred: Background in supporting Medicare, Medicaid, D-SNP, C-SNP, or other managed care populations.

• Preferred: Experience in quality improvement or Stars-related initiatives.

• Preferred: Experience in conducting member outreach and engagement activities, including screening for depression symptoms and other care barriers.

• Preferred: Knowledge of community resources and social determinants of health.

• Preferred: Experience working in a remote setting.

• Preferred: Experience in motivating others to improve their health.

🏝️ Benefits

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Remote work arrangement.

• Home office setup with a dedicated workspace.

• Occasional travel to Humana offices for training or meetings.