Become a part of our caring community and help us put health first
Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary.
KEY ACCOUNTABILITIES
Assist beneficiaries with eligibility process and support the family to ensure enrollment into the ACD and overcome barriers to obtaining required paperwork. Assist with regional transfers in and out of the region and ensure required paperwork is indexed into the electronic records system. Ensure all paperwork and documentation is notated within the clinical management system.
ASN with care coordination efforts of assigned beneficiary caseloads to include but not limited to managing incoming & out-going communications to manage provide placement; researching time availability and beneficiary preferences that will impact access to care; identifying available local resources based on beneficiary needs; ECHO enrollment issues, identification of ABA providers and other non-clinical beneficiary concerns. Includes education and referrals for initial outcome measure completion for seamless start to ABA services. Interface with providers as necessary and appropriate for issue follow-up and resolution.
Families who are dependents of active-duty service members must be enrolled with EFMP and associate will educate and register them in the ECHO registration portal and begin the provisional period. Assist in monitoring ECHO faxes and provisional paperwork to facilitate transition to permanent status. Ensure documentation is accurate and documented in all applicable systems. Be able to communicate ECHO requirements to beneficiaries to ensure they provide necessary paperwork so there are no gaps in care.
Communicates effectively with other departments to coordinate needs of beneficiaries, support the goals of the ACD and exhibits Humana's values at all times. Any other duties as needed.
Use your skills to make an impact
Required Qualifications
Our Department of Defense contract requires U.S. Citizenship
Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)
HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.
3 years experience working in a clinic, hospital case management, managed care/ healthcare setting - working with providers, taking phone calls from patients/providers, handling referrals and assisting with coordinating care for patients. Helping patients with eligibility.
Preferred Qualifications
Military health care service experience or working knowledge of TRICARE ACD program.
Bachelor's degree in social work, psychology, or related health discipline from an accredited university.
Knowledge of Autism Spectrum Disorder, specifically about Applied Behavior Analysis and other related therapies.
Work at Home Requirements
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
Associates 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 associates 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
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.
$40,000 - $52,300 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.
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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. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
