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Humana

Sells Medicare health plans and runs senior clinics

Field Care Coordinator

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeFort Lauderdale, FL, USA$53.7k - $72.6k /yr

About the Job

Requirements

  • Meet one of the following qualifications: a bachelor's degree in Health Services, Social Work, or Psychology with at least 2 years of relevant experience; a Florida-licensed Registered Nurse with at least 2 years of relevant experience; a Florida-licensed Licensed Practical Nurse with at least 4 years of relevant experience; or a Case Worker with at least 6 years of Health Services or Case Management experience.
  • Prior experience with Medicare and Medicaid recipients.
  • AHCA fingerprinting is required.
  • The role is patient-facing and requires tuberculosis screening if selected.
  • A valid state driver's license and proof of personal vehicle liability insurance with limits of at least 100,000/300,000/100,000 are required.
  • Home internet service must provide at least 25 Mbps download and 10 Mbps upload; wireless, wired cable, or DSL is suggested. A dedicated workspace without ongoing interruptions is required to protect member PHI/HIPAA information.
  • Must work Monday through Friday, 8:30 a.m. to 5:00 p.m.
  • The position is subject to Florida Level 2 background screening through the Care Provider Background Screening Clearinghouse.

Responsibilities

  • Visit Medicaid members in their homes, assisted living facilities, long-term care facilities, and other care settings; local travel is 75–90%.
  • Assess and evaluate members' needs and requirements to establish member-specific care plans.
  • Ensure members receive services in the least restrictive setting to achieve or maintain optimal well-being.
  • Plan and implement interventions to meet members' needs.
  • Coordinate services and monitor and evaluate case management plans against members' personal goals.
  • Guide members and families toward resources appropriate for their care.
  • Facilitate interactions with other payer sources, providers, interdisciplinary teams, and others involved in members' care, as appropriate and required by the comprehensive contract.

Desired Qualifications

  • Prior nursing home diversion or long-term care case management experience.
  • Bilingual English/Spanish ability and ability to pass a language proficiency exam.
  • Experience with electronic case-note documentation and documenting in multiple computer applications or systems.
  • Experience working with the geriatric population.
  • Experience with health promotion, coaching, and wellness.
  • Knowledge of community health and social service agencies and additional community resources.
  • 701B certification.
  • Medication application (RFA) experience.

About the Company

Humana

Sells Medicare health plans and runs senior clinics

Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.

Company size
10,001+
Company stage
IPO
Headquarters
Louisville, KY
Founded
1961

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