Job Description

Humana Healthy Horizons in Virginia is looking for Community Health Workers to contribute to the administration of care management. They provide 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 facilitate interaction with resources appropriate for the care and wellbeing of members. The Community Health Worker’s work assignments are often straightforward and of moderate complexity. Community Health Workers (CHW) serves as members of our Medicaid enrollee centric Comprehensive Care Support teams. The CHW applies a hands-on approach to enrollee engagement to support case management functions, address health related social needs (HRSN) to improve self-management of chronic conditions, navigate the healthcare system, and promote prevention and health education that is tailored to the needs of the communities we serve. The CHW leverages their knowledge of the community and shared life experience to inform their interactions with enrollees and Humana’s community partners. Works collaboratively with other Humana associates as a member of Humana’s Comprehensive Care Support team, including case managers, housing specialists, and HRSN coordinators. Conducts in-person assessment(s) to understand member care needs, preferences, and socioeconomic barriers and evaluate the home environment. Assesses member barriers to healthy living and accessing healthcare services and assist enrollees with scheduling physical health and behavioral health (BH) office visits, addressing barriers to appointment attendance. Acts as a member advocate with providers, community resources, schools, and others, including accompanying members to provider office visits as requested. Assists member with navigating health care and social service systems and coordinate access to basic needs (e.g. housing, food, income, transportation). Promotes and monitors member adherence with their care plan and provide motivational interviewing to support medication and treatment adherence. Provides social support to help boost member’s morale and sense of self-worth, serving as a trustworthy, reliable, non-judgmental, consistent, and accepting member of the member’s multi-disciplinary team. Supports member self-management through the provision of culturally appropriate health education and health coaching. Attends Humana community events to connect with members and provide education on case management services. Conducts research and in-person outreach to locate difficult-to-contact members to increase assessment completion and participation in clinical programs. May assist with Health Risk Screenings (MMHS). Builds and maintains relationships with providers and community resources to support member referrals and implement community assessments to identify community resource gaps. Supports the implementation of Humana’s Readmission Prevention and ED Diversion program.

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