Overview
Long Term Care Functional Screener Jobs in Madison, WI at Humana
Become a part of our caring community and help us put health first
Humana/iCare is seeking a Long Term Care Functional Screener to join the growing team in the Family Care Partnership (FCP) program. The Long Term Care Functional Screener (LTCFS) is responsible for conducting WI Adult Long Term Care Functional Rescreens for re-determination of members functional program eligibility. The Screener is responsible for screening members within the iCare Family Care Partnership service areas, as well as participate in all iCare and WI State LTCFS required compliance and quality assurance activities. Share your talents and develop your skills all while doing your part to improve the lives of others.
Essential Duties and Responsibilities:
Coordinate appointments with members or legal representative to complete Annual and Enrollment redetermination of functional eligibility within member’s home; conduct rescreens due to member change in functional abilities for redetermination of eligibility as identified by Interdisciplinary Team (IDT).
Utilize established methodology of the Wisconsin LTCFS process to collect member-centered data regarding functional abilities, health status and needs-based use of personal and professional supports and verify consistency of member specific data between functional assessment and member’s record to ensure members functional needs are accurately reflected.
Collaborate with the IDT to ensure all assigned LTCFS rescreens are completed within the required time frame.
Submit information collected during face-to face interview and collaborative verification into WI State internet-based program while maintaining compliance of state mandated timelines & appropriate professional utilization of LTCFS Instruction Manual.
Effectively maintain updates of status to assigned members LTCFS rescreens on department spreadsheets to ensure adherence of State of WI and iCare LTCFS timeframes. Review Level of Care for iCare members including follow-up consultation with Grievance and Appeals or Enrollment/Eligibility/Fiscal staff.
Provide 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 or overall program eligibility.
Attend meetings and trainings as required to maintain & enhance knowledge of agency processes & the Long-Term Care Functional Screen.
Maintain LTCFS certification via completion of WI biannual Continuing Skills Test.
Use your skills to make an impact
Required Qualifications:
Bachelor of Arts or Science degree or more advanced degree in a health or human services related field (i.e., social work, rehabilitation, psychology), or have a license to practice as a registered nurse in Wisconsin.
Minimum of one (1) year experience working with at least one of the Family Care Partnership target group populations: Frail Elder, Adults with physical disability, or intellectual/developmental disability.
Knowledge of public long-term care, managed care, & functional eligibility.
Available for daytime travel within all FCP iCare service area(s): Dane and Sauk Counties.
Long Term Care Functional Screener (LTCFS) Required Qualifications
Must be certified as WI Adult Long Term Care Functional Screener OR If you are not currently certified, you must pass the Adult Long-term Care Functional Screen certification modules (80% or higher on each module) within 45 days of hire.
Preferred Qualifications:
Current WI Adult LTCFS certification.
Additional Information
Workstyle: Field. 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.
Travel: up to 50%. Travel will be primarily throughout Dane and Sauk Counties; could require assisting with coverage in Milwaukee, Racine, and Kenosha Counties, if needed.
Typical Work Days/Hours: Monday through Friday; 8:30 am – 5:00 pm (CST)
Limited Geography Remote – This is a remote position but located within a specific geography.
WAH Internet Requirements
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.
TB
This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Driving
This role is part of Humana’s driver safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
Benefits
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Parental and caregiver leave
Employee charity matching program
Network Resource Groups (NRGs)
Career development opportunities
HireVue
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
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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.
$47,700 – $65,600 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.
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 because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
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Title: Long Term Care Functional Screener
Company: Humana
Location: Madison, WI
