Care Management Support Professional

Become a part of our caring community and help us put health first
 Humana Healthy Horizons in Florida is seeking a Care Management Support Professional to serve members in Broward County. The Care Management Support Professional (CMSP) will contribute to the administration of Care Management and Utilization Management. The individual in this role provides non-clinical support to the assessment and evaluation of member’s needs and requirements to achieve or maintain optimal wellness by guiding member/families toward and facilitating interaction with appropriate resources for their care and wellbeing. The CMSP collaborates with Case Managers (CMs) and Utilization Management (UM) Nurses to address co-occurring physical health, behavioral health, and social factors affecting members. The individual improves members’ understanding of and ability to self-manage their chronic conditions and Social Determinants of Health (SDoH) and work to reduce disparities in outcomes associated with chronic conditions and social determinants of health.

This position is a field-based role and requires 80% travel within the region, about 4 days weekly, and residence in Broward County.

The Care Management Support Professional (CMSP) builds visibility and credibility of Humana’s products and services throughout the community via chats, posts, and interactions. The individual in this role engages new community members and strategizes methods to scale communities and drive connections among all community members. The CMSP understands professional concepts and standards, regulations, strategies, and operating standards. This individual makes decisions about their own work approach and priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

• Conducts research and in-person outreach to locate difficult-to-contact enrollees to increase assessment completion and participation in clinical programs.
• Conducts in-person non-clinical assessments to understand enrollee care needs, preferences, and socioeconomic barriers, and evaluate the home environment as needed.
• Works collaboratively with other Humana associates as a member of Humana’s Care Management Support teams.
• Serves as a member of enrollee multi-disciplinary care teams (MDT) as requested.
• Assists enrollees with scheduling physical health and behavioral health office visits and addressing barriers to appointment attendance.
• Assesses enrollee barriers to healthy living and accessing healthcare services and arranges necessary social services and supports.
• Acts as an enrollee advocate with providers, community resources, schools, and others, including accompanying enrollees to provider office visits as requested.
• Locates enrollees when they miss appointments to determine the reason and problem-solve to address barriers to care.
• Monitors enrollee compliance with their care plan and provides …