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Humana

Sells Medicare health plans and runs senior clinics

Case Manager

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • A bachelor's degree in human services or a related field and at least 1 year of experience serving frail elders or adults with intellectual, developmental, or physical disabilities; alternatively, a bachelor's degree in another field and at least 3 years of such experience.
  • A valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
  • A valid driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits are required to participate in the driver safety program.
  • A TB screening is required if selected for this patient-facing role.
  • For home or hybrid home/office employees, self-provided 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.

Responsibilities

  • Assess members' health and safety needs, strengths, interests, and preferences to develop a comprehensive Member Care Plan.
  • Coordinate with a Field Care Nurse to provide services addressing members' health and safety needs and ensure support is delivered in the least restrictive environment according to the Member Care Plan.
  • Conduct face-to-face social assessments upon enrollment and at least every six months, typically at the member's residence.
  • Conduct quarterly in-person visits and maintain monthly phone contact with members.
  • Arrange support services related to social integration, community resources, employment, housing, and other non-medical needs.
  • Ensure cost-effective service delivery.
  • Evaluate risk factors and provide education to members.
  • Maintain accurate documentation, including case notes, service authorizations, and Member Care Plan updates.
  • Travel to client or assignment locations and Humana offices for work-related visits, training, or meetings; mileage reimbursement is provided for eligible work-related travel.

Desired Qualifications

  • Reside within 45 minutes or less of the assigned coverage area.
  • Case management experience.
  • Experience with electronic case note documentation.
  • Knowledge of community health and social service agencies and additional community resources.

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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