Transition/Custodial Prevention Specialist
$59.3k - $80.9k/yr+ Performance-based bonus incentive
Junior
Bachelor's
Batavia, IL, USA+13 moreMore locations: Sycamore, IL, USA | Maple Park, IL, USA | Sandwich, IL, USA | Waterman, IL, USA | North Aurora, IL, USA | DeKalb, IL, USA | Sugar Grove, IL, USA | Genoa, IL, USA | Geneva, IL, USA | Elgin, IL, USA | Elburn, IL, USA | Illinois, USA | Aurora, IL, USA
RemoteIllinois, United States (remote): Must reside in Illinois.
Social & Community ServicesCase Management & Advocacy
About the job
Requirements
- Must reside in Illinois.
- A bachelor's degree in social sciences, social work, human services, or a related field is required.
- At least two years of experience working with Medicare and Medicaid recipients, long-term care services, Home and Community-Based Services, or managed care organizations is required.
- At least one year of professional experience working with members in custodial and transitional care is required.
- Experience using a variety of electronic information applications and software programs, including electronic medical records, is required.
- Must be able to travel in the region to meet face-to-face with members and/or their families, community partners, and care teams.
- Must have a valid state driver's license and maintain personal vehicle liability insurance at the applicable minimum coverage limits.
- Must complete tuberculosis screening if selected for this patient-facing role.
Responsibilities
- Provide specialized support for members receiving Long Term Services and Support, focusing on health-related social needs, psychosocial support, and ensuring services meet members' needs.
- Support members residing in nursing facilities by building relationships with facility staff, advocating for member care including access to behavioral health services, and assessing members' desire and ability to return to the community.
- Contact members by telephone and face-to-face to establish goals and priorities, evaluate resources, develop plans of care, identify long-term services and support providers and community partnerships, and coordinate services and supports that address the needs and goals of members and caregivers through person-centered approaches.
- Help members and caregivers access long-term services and support, social, housing, educational, and other services, regardless of funding source, using an interdisciplinary approach.
- Develop and modify Individual Service Plans and involve applicable care team members in care planning.
- Support members as they navigate long-term services and support and related environmental and social needs.
- Use available member information to prevent duplicative assessments.
- Recommend appropriate Home and Community-Based Services to enable members' independence in the community.
- Facilitate interactions with other payer sources, providers, and interdisciplinary care teams.
- Educate members on maintaining Medicaid eligibility.
- Assist with entering annual Level of Care assessments into the state portal.
Desired Qualifications
- An active, unrestricted Illinois Licensed Professional Counselor, Licensed Social Worker, or Registered Nurse license is preferred.
- Nursing home diversion or long-term care case management experience is preferred.
- Experience working with a waiver program is preferred.
- Experience working with Medicare and Medicaid recipients is preferred.
- Experience working with complex health populations is preferred.
- Experience with health promotion, coaching, and wellness is preferred.
- Knowledge of community health and social service agencies and additional community resources is preferred.
- Bilingual or multilingual ability in English and Spanish, Arabic, Vietnamese, Amharic, Urdu, or another language is preferred.
About the company
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, Kentucky
Founded
1961
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Simplify's Take
What believers are saying
- Enrollment is surging: in July 2026 Humana affirmed about 25% individual Medicare Advantage membership growth for 2026.
- Owned clinics create clinical careers: CenterWell Senior Primary Care added 130,900 patients, up 27%, in early 2026.
- Medicaid is widening: Illinois chose Humana in June 2026 to run Medicaid coverage statewide.
What critics are saying
- Low quality scores cut Medicare bonuses: only 20% of Humana's members sat in 4-star or better plans for 2026.
- The insurer is shrinking to save margins: about 600,000 Medicare Advantage members got plan-closure notices in October 2026.
- Stock grants carry risk: in July 2026 Humana cut its 2026 GAAP earnings floor to $6.52 a share from $8.36.
What makes Humana unique
- Military families are a second market: Humana runs the Pentagon's TRICARE health plan across 24 eastern states and Washington, DC.
- Florida anchors the business: Humana's Medicare Advantage contracts there produced 14% of its 2025 revenue.
- Medicaid is a quiet second insurer: Humana covers over 1.54 million low-income members across 11 states.
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Benefits
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Disability Insurance
- Unlimited Paid Time Off
- Paid Vacation
- Paid Parental Leave
- Short-term Disability
- Long-term Disability
- 401(k) Retirement Plan
- 401(k) Company Match