[Hiring] Care Coach @Humana

Role Description

The Care Coach 2 supports South Carolina Medicaid members by assessing health and social needs, developing individualized plans, coordinating services, and helping members and families connect with resources that promote optimal health, independence, and well-being. Working in partnership with the South Carolina care management team, this role provides field-based assessment, transition support, resource navigation, and ongoing monitoring across care settings.

Assignments are varied and frequently require interpretation, independent judgment, and selection of the appropriate course of action. The Care Coach 2 works with minimal direction, seeks guidance when needed, follows established guidelines and procedures, and understands how daily responsibilities support departmental, segment, and organizational strategies.

You will report to the Manager, Care Management.

• Conduct telephonic and face-to-face assessments to evaluate each member's health, functional, environmental, psychosocial, and support needs.
• Develop and maintain individualized, member-centered care plans that reflect identified needs, personal goals, preferences, and the least restrictive appropriate care setting.
• Plan and implement interventions, coordinate services, and monitor progress using assessment findings, available data, member conversations, and active care planning.
• Identify and resolve barriers that may hinder effective care, engagement, transitions, or achievement of desired outcomes.
• Guide members and families to appropriate clinical, community, social, and payer resources, and facilitate collaboration with providers, interdisciplinary teams, and others involved in the member's care.
• Support safe and effective transitions across care settings and provide additional transition support when business needs require.
• Visit members in their homes, assisted living facilities, long-term care facilities, and other care or community settings throughout the assigned South Carolina service area.
• Document assessments, care plans, interventions, member interactions, referrals, and outcomes accurately and timely in required systems.
• Apply independent judgment in occasionally ambiguous situations, adapt work methods and assignments to changing business needs, and follow established guidelines and procedures.

Qualifications

• Must Reside in South Carolina
• Bachelor's degree in a health and human services field.
• Two or more years of relevant experience in care coordination, case management, health and human services, or a related field.
• Experience assessing needs, developing service or care plans, coordinating resources, and documenting member interactions and outcomes.
• Intermediate to advanced proficiency with Microsoft Word, Excel, and Outlook.
• Strong verbal and written communication, organization, critical-thinking, and problem-solving skills.
• Ability to manage varied assignments, meet tight deadlines, work independently with minimal direction, and adapt to changing priorities in a fast-paced environment.
• Ability to travel to meet with South Carolina Medicaid members in homes, assisted living facilities, long-term care facilities, and other care or community settings.
• This patient-facing role is part of Humana's Tuberculosis screening program. The selected candidate will be required to complete TB screening.
• A dedicated home office with a door that can be locked to maintain continuous privacy and protect member information.

Preferred Qualifications

• Master's degree in a health and human services field.
• Applicable state license in the candidate's field of study.
• Certified Case Manager credential.
• Experience with InterQual or MCG guidelines.
• Experience supporting Medicare or Medicaid populations.
• Experience with electronic case-note documentation and multiple computer applications or systems.
• Experience with health promotion, coaching, wellness, community health, social service agencies, and community resources.

Additional Information

• Workstyle: This is a remote, field-based position serving members throughout an assigned South Carolina service area. The role requires a dedicated workspace that protects member privacy and complies with PHI and HIPAA requirements.
• Travel: This role requires at least 50% regional travel for face-to-face meetings and field-based interactions with enrollees, their families, providers, and staff. Occasional travel to a Humana office for training or meetings may also be required.
• Scheduled Weekly Hours: 40
• Pay Range: The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year.
• This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.