Description
The Transition Coordinator (Care Coach 2) evaluates members' needs and requirements to achieve and maintain an optimal wellness state.
Responsibilities:
- Support ongoing member transitions in and out of Indiana Medicaid programs, Contractor's enrollment, and among care settings.
- Complete transitions and assist with planning and preparation for them, and follow-up care after.
- Collaborate with the Member Advocate Coordinator and other member-focused departments to ensure continuity and coordination of care and member and provider communication.
- Ensure transfer and receipt of all outstanding prior authorization decisions, utilization management data, and clinical information.
- Help with transitions from custodial settings to home and community-based settings.
- Conduct telephonic and in-person meetings within an assigned region to work with various stakeholders.
- Assess and evaluate members' needs to establish a member-specific care plan and coordinate services.
- Ensure members are transitioning to the least restrictive setting to achieve or maintain well-being.
- Guide members and families towards resources appropriate for their care.
Requirements:
- Bachelor's degree in a health and human services field.
- 2 or more years of relevant experience.
- Valid state driver's license and personal vehicle liability insurance.
- Separate room with a locked door for home office use.
- Reside in one of the following Indiana counties: Laporte, St Joseph, Marshall, Elkhart, or Kosciusko.
Preferred Qualifications:
- Master's degree.
- Applicable state license in field of study.
- Case Management Certification (CCM).
- Interqual or Milliman experience.
- Prior experience with Medicare & Medicaid recipients.
- Experience with electronic case note documentation and multiple computer applications/systems.
- Knowledge of community health and social service agencies.
Additional Information:
- Work from home requirements: minimum download speed of 25 Mbps and upload speed of 10 Mbps.
- Occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours: 40
Pay Range: $59,300 - $80,900 per year
Benefits:
- Medical, dental, and vision benefits.
- 401(k) retirement savings plan.
- Time off, including paid time off, company and personal holidays, paid parental and caregiver leave.
- Short-term and long-term disability.
- Life insurance.