Care Coordinator

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

📋 Description

• Act as the primary contact for newly enrolled members of Illinois Medicaid.

• Engage in proactive outreach efforts to connect with members.

• Conduct thorough Health Risk Assessments (HRAs).

• Assess immediate healthcare and social service requirements.

• Visit members at their homes, Assisted Living Facilities, Long-Term Care Facilities, and other care environments.

• Travel locally in the field approximately 75% of the time.

• Evaluate care needs through both telephonic and face-to-face assessments.

• Ensure that enrollees receive services in the least restrictive environment.

• Identify and address obstacles to effective care.

• Design and implement appropriate interventions.

• Coordinate, monitor, and assess case management plans relative to individual goals.

• Continuously track patient care and progress towards intended outcomes.

• Address immediate and urgent care gaps and access issues.

• Assist enrollees in submitting grievances and appeals.

• Clarify MCO requirements, services, and benefits.

• Provide information and referrals to community resources.

• Direct enrollees and their families to suitable care resources.

• Facilitate collaboration with payers, providers, interdisciplinary teams, and other care participants.

• Aid in the transition to ongoing care management services.

⛳️ Requirements

• Bachelor's degree in social sciences, social work, human services, or a related discipline; or an unrestricted Illinois LPN with at least one year of experience in conducting comprehensive assessments and delivering formal services for the elderly; or Licensed Professional Counselor (LPC); or Licensed Social Worker (LSW).

• Must be a resident of the state of Illinois.

• At least 1 year of experience in healthcare and/or case management.

• A minimum of 1 year of experience working with Medicare & Medicaid recipients and/or in long-term care and/or Home and Community-based services and/or with managed care organizations.

• Intermediate to advanced proficiency in computer skills.

• Familiarity with Microsoft Word, Excel, and Outlook.

• Experience utilizing electronic information applications/software programs, including electronic medical records.

• Valid Illinois driver's license.

• Personal vehicle liability insurance that meets state minimum requirements or specified Humana limits.

• Must complete TB screening upon selection.

• Availability to work Monday–Friday, 8 am–5 pm CST, with flexibility and potential additional hours as business needs dictate.

• Home internet connection with a minimum of 25 Mbps download and 10 Mbps upload speeds.

• A dedicated workspace free from interruptions to safeguard member PHI/HIPAA information.

🏝️ 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.

• Flexible work schedule.

• Remote work options.

• Dedicated home workspace support to protect member PHI/HIPAA information.