Become a part of our caring community and help us put health first
 

Humana is seeking a Long Term Care Functional Screen Specialist to join the Inclusa team to serve members in the Wisconsin Family Care (FC) program. In this role, you will be responsible for using the tool designed by the State Department of Health Services (DHS) to assess functional status, level of care, and ongoing eligibility of Family Care members.

• Upon assignment, schedules appointments with members to complete an annual re-determination of functional eligibility, or a re-determination of eligibility based on changes in functional abilities reported by Member Support Coordination (MSC) staff. Screens are expected to be scheduled in a manner which maximizes organizational resources, including time/travel expenses.
• Uses the screening tool designed by DHS to gather information about each individual’s functional abilities, health status, and personal and professional supports required to meet his or her desired level of functioning.
• Pending the revelation of needs or concerns beyond the scope of the functional screen, refers members to staff of Inclusa or an Aging and Disability Resource Center.
• Responds to urgent situations and refers individuals for crisis intervention, as necessary.
• Maintains up-to-date online member information regarding functional abilities, demographics, and appropriate contacts.
• Works directly with MSC staff to ensure consistency between the information gathered during a member’s functional assessment and member-specific data contained in internal records.
• Conducts face-to-face interviews with individuals, usually in their homes, to perform the functional screen. Enters the information gathered into an internet-based program that, based on the data collected during a face-to-face interview, calculates a level of care for the individual.
• Provides appropriate notice of member rights, in accordance with contractual requirements, to members who experience a change in level of care that may impact the benefit package one is entitled to or overall program eligibility.
• Submits timely, accurate, and complete documentation in accordance with established guidelines and processes.
• Attends meetings and training as needed or required to maintain knowledge of agency processes, the long-term care functional screening tool, and/or any changes to process or the screening tool resulting from new state directives.
• Participates in quality assurance activities that ensure competence and inter-rater reliability among all staff certified to use the statewide long-term care functional screen tool.
• Once obtained, maintains certification to complete functional eligibility screens by completing and passing continuing skills testing as required by the State of Wisconsin.
• Applies good professional judgment in documentation by demonstrating respect for members and maintaining screen integrity when reviewing and completing assessments.

Use your skills to make an impact
 

Required Qualifications

• Four-year bachelor’s degree in a Health or Human Services related field with one (1) year of experience working with at least one of the Family Care target populations OR be a Wisconsin licensed Registered Nurse with one (1) year of experience working with at least one of the Family Care target populations.

***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities***

Long Term Care Functional Screener (LTCFS) Required Qualifications

• Selected individual must meet requirements and successfully complete online screener certification training course(s) and become certified as a functional screener.

Additional Information

• Workstyle: 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.
• Work Location: Brown, Outagamie, Kewaunee Counties
• Travel: up to 50% throughout Brown, Outagamie, Kewaunee Counties, WI and surrounding areas.
• Typical Work Days/Hours: Monday – Friday, 8:00 am – 4:30 pm CST

WAH Internet Statement

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 suggested.
• Satellite, cellular and microwave connecti