Humana · 2 days ago
Functional Screen Specialist - Sheboygan WI
Maximize your interview chances
Health CareHealth Insurance
Insider Connection @Humana
Get 3x more responses when you reach out via email instead of LinkedIn.
Responsibilities
Upon assignment, schedules appointments with members to complete an annual re-determination of functional eligibility, or a re-determination of eligibility based on changes in functional abilities reported by Member Support Coordination (MSC) staff. Screens are expected to be scheduled in a manner which maximizes organizational resources, including time/travel expenses.
Uses the screening tool designed by DHS to gather information about each individual’s functional abilities, health status, and personal and professional supports required to meet his or her desired level of functioning.
Pending the revelation of needs or concerns beyond the scope of the functional screen, refers members to staff of Inclusa or an Aging and Disability Resource Center.
Responds to urgent situations and refers individuals for crisis intervention, as necessary.
Maintains up-to-date online member information regarding functional abilities, demographics, and appropriate contacts.
Works directly with MSC staff to ensure consistency between the information gathered during a member’s functional assessment and member-specific data contained in internal records.
Conducts face-to-face interviews with individuals, usually in their homes, to perform the functional screen. Enters the information gathered into an internet-based program that, based on the data collected during a face-to-face interview, calculates a level of care for the individual.
Provides 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 one is entitled to or overall program eligibility.
Submits timely, accurate, and complete documentation in accordance with established guidelines and processes.
Attends meetings and training as needed or required to maintain knowledge of agency processes, the long-term care functional screening tool, and/or any changes to process or the screening tool resulting from new state directives.
Participates in quality assurance activities that ensure competence and inter-rater reliability among all staff certified to use the statewide long-term care functional screen tool.
Once obtained, maintains certification to complete functional eligibility screens by completing and passing continuing skills testing as required by the State of Wisconsin.
Applies good professional judgment in documentation by demonstrating respect for members and maintaining screen integrity when reviewing and completing assessments.
Qualification
Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.
Required
Four-year bachelor’s degree in a Health or Human Services related field with one (1) year of experience working with at least one of the Family Care target populations OR be a Wisconsin licensed Registered Nurse with one (1) year of experience working with at least one of the Family Care target populations.
Selected individual must meet requirements and successfully complete online screener certification training course(s) and become certified as a functional screener.
Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
Required to be screened for TB.
Benefits
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
Medical, dental and vision benefits
Short-term and long-term disability
Life insurance
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
Funding
Current Stage
Public CompanyTotal Funding
$6.82B2024-03-11Post Ipo Debt· $2.25B
2023-11-02Post Ipo Debt· $1.32B
2023-02-27Post Ipo Debt· $1.25B
Recent News
MedCity News
2024-11-13
2024-11-12
Company data provided by crunchbase