Care Coordinator

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

📋 Description

• Provide support for Humana's Illinois HealthChoice Medicaid Managed Care program.

• Conduct visits to Medicaid members in their homes, assisted living facilities, long-term care facilities, and other care environments.

• Evaluate the unique care needs of members through both telephonic and in-person assessments.

• Ensure that members receive services in the least restrictive environment possible.

• Identify and address barriers that hinder effective care.

• Create and implement tailored care-plan interventions.

• Coordinate services while monitoring and evaluating case management plans based on members' personal objectives.

• Continuously track member care and progress towards desired results.

• Address immediate and urgent gaps in care and access.

• Assist enrollees with filing grievances and appeals.

• Provide explanations of MCO requirements, services, and benefits.

• Offer information and referrals to community resources.

• Guide members and their families to appropriate care resources.

• Facilitate communication with payers, providers, interdisciplinary teams, and others involved in member care.

• Support either MLTSS or LTSS according to business requirements.

• Travel locally 75–90% of the time to visit members.

• Report to the Manager of Care Management.

⛳️ Requirements

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

• Must be a resident of Illinois.

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

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

• Intermediate to advanced proficiency in computer skills.

• Experience with Microsoft Word, Excel, and Outlook.

• Familiarity with electronic information applications/software programs, including electronic medical records.

• Valid state driver's license required.

• Personal vehicle liability insurance that meets the required limits.

• TB screening required for selected candidates.

• Ability to work Monday–Friday from 8am to 5pm CST, with flexibility depending on business needs.

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

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

🏝️ 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.

• Support for training and meeting travel.