Essential Role Functions and Responsibilities:

• Conduct in-person and telephonic non-clinical assessment(s) to understand enrollee care needs, preferences, and socioeconomic barriers and evaluate the home environment as needed.

• Work collaboratively with other Humana associates as a member of Humana’s Care Management Support teams, including case managers, SDOH coordinators, Community Education Representatives (CER), and the Quality Improvement team that conducts HEDIS outreach.

• Serve as a member of enrollee multi-disciplinary care teams (MDT), as requested.

• Assist enrollees with scheduling physical health and behavioral health (BH) office visits and addressing barriers to appointment attendance.

• Assess enrollee barriers to healthy living and accessing healthcare services and arrange needed social services and supports.

• Act as an enrollee advocate with providers, community resources, schools, and others, including accompanying enrollees to provider office visits as requested.

• Locate enrollees when they miss appointments to find out why the appointment was missed and problem-solve to address barriers to care.

• Monitor enrollee compliance with their care plan and provide motivational interviewing to support medication and treatment adherence.

• Provide social support to help boost enrollees’ morale and sense of self-worth, serving as a trustworthy, reliable, non-judgmental, consistent, and accepting member of the enrollee’s MDT.

• Support enrollee self-management through the provision of culturally appropriate health education and health coaching.

• Serve as a key knowledge source for community services and information for enrollees and other Humana associates.

• Attend Humana community events to connect with enrollees and provide education on case management services.

• Conduct research and in-person outreach to locate difficult-to-contact enrollees to increase assessment completion and participation in clinical programs.

• Build and maintain relationships with providers and community resources to support enrollee identification and referrals.

• Implement community assessments to identify community resource gaps.

Required Qualifications

• Bachelor's degree

• Certified Community Health Worker in the state of Kentucky or willingness to obtain certification within 12 months of hire.

• Minimum 3 years of experience working with members face to face conducting assessments

• Minimum 3 years of professional human services and/or community health worker experience

• Proficient in Microsoft Office (Excel, Word)

• Ability to use a variety of electronic information applications/software programs

Preferred Qualifications

• Prior experience with Medicaid recipients

• Bilingual skills - Language assessment is required to be considered fluent

Workstyle: Combination remote work at home and field based

Location: Must reside in the state of Kentucky or Southern Indiana within 15 minutes of Kentucky border

Schedule: Must be able to work Mon-Fri between the hours of 8:00 AM to 6:00 PM Eastern Time and maintain flexibility to work weekday evenings based on business needs.

Travel: 60-75% typically Monday through Friday, with opportunity to participate in events on the weekends, but is not required.