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

Humana Healthy Horizons in Florida is seeking a Care Management Support Assistant who will contribute to administration of care management. The Care Management Support Assistant (CMSA) provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and wellbeing of members. The CMSA performs varied activities and moderately complex administrative/operational/customer support assignments, performs computations, and typically works on semi-routine assignments.

The Care Management Support Assistant contributes to administration of care management.

• Makes outbound calls to members, addressing identified gaps, completing applicable surveys/documentation and answering questions. Identified needs will primarily be ABA-related (Applied Behavioral Analysis), but can range from housing, transportation, food insecurities, or additional social determinant of health needs or case management needs, such as questions about medical conditions, assistance in finding providers, or where to get care.
• Assists with resolutions needed for ABA-related AHCA complaints or complaints from the Humana Grievance and Appeals Team.
• Assists manager in monitoring ABA queue, building cases and ABA data tracking/reporting.
• Works directly with state agencies to monitor members eligibility.
• Performs varied activities and moderately complex administrative/operational/customer support assignments and performs computations.
• Decisions are typically focused on interpretation of area/department policy and methods for completing assignments.
• Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.
• This role will be responsible for receiving and dialing, performs 50% inbound/outbound call lines.
• Typically works on semi-routine assignments.

Use your skills to make an impact
 

Required Qualifications

• At least two (2) years of administrative support experience.
• Proficiency with MS Office Word, Excel, Outlook, typing and computer navigation skills using multiple systems, platforms, and an ability to troubleshoot and resolve general technical difficulties in a remote environment.
• Experience in customer service.
• Experience managing multiple or competing priorities.
• ACHA Level II background check is required for this role.

Preferred Qualifications

• Associate's degree.
• Experience working with members who have received Applied Behavioral Analysis.
• Administrative support experience in a healthcare industry.
• Knowledge of Medicare and Medicaid guidelines.
• Familiarity with care and well-being resources.
• Bilingual English and Creole/Spanish - please review language assessment criteria.

Additional Information

• Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
• Location: preference is to reside in Florida.
• Schedule: Monday-Friday 8:30 AM-5:00 PM Eastern Standard Time (EST)

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 recommended; wireless, wired cable or DSL connection is suggested.
• 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.

Language Assessment Requirement

Any Humana employee 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.

Interview F