Care Coach - Service Facilitator For Consumer Directed Services - Remote Eligible

Join Our Caring Community

This role involves meeting members in the field at their home, Nursing Facility (NF) or location of the member's choice, spending quality time assessing their goals, needs and barriers and then connecting our members with quality services to promote their ultimate well-being and drive person centered health outcomes.

Position Responsibilities:

• Initial Home Visit and Care Planning
• Member and Employer of Record (EOR) Training
• Timesheet and Service Verification
• Documentation and Compliance
• Ongoing Support and Monitoring
• Annual Medicaid Waiver Redetermination
• Availability and Member Support
• Back-Up Planning and Service Continuity
• Internal Collaboration
• Quality Assurance and Risk Management

Required Qualifications:

• Bachelor's degree in a health and human service field (such as Social Work, Nursing, Public Health, Psychology, or Human Services) OR LPN OR equivalent relevant direct care experience.
• Minimum of one year of experience in service facilitation or in a community-based setting supporting individuals with disabilities, children, or older adults.
• Must reside in Virginia (preferably Roanoke, upper Charlottesville, Harrisonburg and Winchester)
• The company requires successful completion of DMAS-approved service facilitator training and competency assessment within 90 days of hire. The minimum score for this assessment is 80%. Additionally, the employee must pursue ongoing recertification every five years. To do so, they must provide current certification.
• Proficiency in service facilitation best practices, including comprehensive understanding of Virginia state law and federal regulations related to Medicaid waivers and consumer-directed services. Familiarity with DMAS forms 97 AB, 98, 99, 100, 486, 488, 489, and FARF.
• Demonstrated competencies in assessing functional limitations, care planning, interviewing, documentation, cultural competence, and independent work.
• Commitment to privacy, safety, and compliance standards in accordance with corporate policies and all applicable federal and state regulations. Ability to manage confidential information with discretion and integrity, in compliance with HIPAA and organizational privacy standards.
• Experience working with electronic systems and proficiency in Microsoft Office applications, including Excel, Word, PowerPoint, and Teams.
• Maintain up-to-date personnel records, including documentation of all training, competency assessments, professional references, and background checks.
• Ensure completion and retention of criminal background checks and the Virginia Department of Social Services Child Protective Services Central Registry
• Verify that candidates are not debarred, suspended, or excluded from participation in federal healthcare programs, as confirmed through the LEIE database.
• Obtain/Maintain a notary public commission within 90 days of employment.

Preferred Qualifications:

• Bilingual proficiency in English and another language.
• Experience working with Medicaid or managed care populations.
• Familiarity with Humana's electronic health record systems.
• Certification in case management (such as CCM, ACM, or equivalent) or progress toward such certification.
• Previous experience in telehealth or virtual care coordination environments

Additional Information:

Workstyle: Field - This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.

Workdays and Hours: Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs and requires approval.

Screening: This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Travel, Driver's License, Transportation, Insurance: Must be willing to travel at least 30-50% of the time within your assigned Region where you reside in Northern Virginia, to conduct field visits with members in your assigned area. Travel requirements may vary based on member tier level. May need to attend onsite meetings occasionally in Humana Healthy Horizons office in Glen Allen, VA.

Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Humana's Driver Safety Program: This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance.

• Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Mileage reimbursement is provided for work-related travel. Eligible mileage includes:

• Travel from your home to your first work location of the day.
• Travel between client or assignment locations during the workday.
• Travel from your final work location back to your home.

Work at Home Guidance: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range: $53,700 - $72,600 per year

Description of Benefits: Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer: It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.