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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in coordinating care and driving health interventions to improve member outcomes, with a strong focus on quality performance and adherence to treatment plans. Proficient in navigating healthcare systems and collaborating with diverse stakeholders to address barriers to care and enhance member engagement.
Highest-signal resume keywords
Direct Patient Care ExperienceCare CoordinationQuality Improvement InitiativesTelephonic OutreachHealthcare Documentation Systems
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care CoordinationPatient Care ExperienceQuality ImprovementTelephonic OutreachHealthcare DocumentationData AssessmentPreventive Care EducationElectronic Medical RecordsMicrosoft Office ProficiencyRegulatory Compliance
Soft Skills
Strong Communication SkillsInterpersonal SkillsOrganizational SkillsAttention to DetailAdaptability
Tools & Technologies
AutodialerHealthcare Documentation SystemsMultiple Computer SystemsElectronic Medical Records
Industry Keywords
Medicare AdvantageManaged CareCommunity ResourcesSocial Determinants of HealthStars ProgramsDepression ScreeningHigh-Risk Chronic ConditionsGeriatric PopulationsVulnerable PopulationsLow-Income Populations
About the role
Key responsibilities & impact- Evaluate member needs and coordinate care
- Drive interventions supporting improved health outcomes, member experience, and quality performance
- Collaborate with members, caregivers, providers, community organizations, and internal partners
- Identify and resolve barriers to care
- Close care gaps and promote adherence to treatment plans across Humana's Medicare Advantage populations
- Engage members in Stars and quality initiatives, including Depression Screening and Follow-Up (DSF) and Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC)
- Support multiple Stars programs and evolving quality improvement initiatives
- Conduct proactive telephonic outreach using an autodialer and approved communication channels
- Review data and complete structured assessments of clinical, financial, functional, and social needs
- Educate members about preventive care
- Connect members with healthcare, community, and social support resources
- Collaborate with care managers, providers, and multidisciplinary partners
- Document assessments, outreach, and outcomes accurately and timely
- Follow program, regulatory, compliance, and documentation requirements
- Navigate multiple computer systems in a fast-paced, structured environment
- Adapt communication and workflow priorities for diverse populations and changing business needs
Requirements
What you’ll need- Associate degree in any field
- At least two (2) years of direct adult patient care experience, such as long-term care, home- and community-based services, a hospital or facility setting, case management, or a managed care organization
- Experience collaborating with members of a healthcare team
- Strong computer proficiency
- Ability to learn and navigate multiple software applications, including electronic medical records
- Applicants who currently hold an RN, LPN, LVN, APRN, NP, LMSW, or LCSW license are not eligible for consideration
- Strong communication and interpersonal skills
- Strong organizational skills and attention to detail
- Intermediate proficiency with Microsoft Office applications and healthcare documentation systems
- Ability to work independently, manage competing priorities, and adapt quickly in a fast-paced environment
- Self-provided internet service with at least 25 Mbps download speed and 10 Mbps upload speed
- Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information
- Florida applicants from a Florida home-based work location are subject to Florida Level 2 background screening
- Preferred: Experience in a telephonic environment working with geriatric, vulnerable, and/or low-income populations
- Preferred: Experience supporting Medicare, Medicaid, D-SNP, C-SNP, or other managed care populations
- Preferred: Experience supporting quality improvement or Stars-related initiatives
- Preferred: Experience conducting member outreach and engagement activities, including screening for depression symptoms and other barriers of care
- Preferred: Knowledge of community resources and social determinants of health
- Preferred: Experience working in a remote environment
- Preferred: Experience motivating others to improve their health
Benefits
Comp & perks- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Remote work arrangement
- Home office work setup with dedicated workspace
- Occasional travel to Humana offices for training or meetings