Functional Screen Specialist - Sheboygan WI

Become a part of our caring community and help us put health first
 Humana is seeking a Long Term Care Functional Screen Specialist to join the Inclusa team to serve members in the Wisconsin Family Care (FC) program. In this role, you will be responsible for using the tool designed by the State Department of Health Services (DHS) to assess functional status, level of care, and ongoing eligibility of Family Care members.

• 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.

Use your skills to make an impact
 

Required Qualifications

• 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.

***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities***

Long Term Care Functional Screener (LTCFS) Required Qualifications

• Selected individual must meet requirements and successfully complete online screener certification training course(s) and become certified as a functional screener.

Additional Information

• Workstyle: 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.
• Work Location: Sheboygan, WI primarily, with travel from Sheboygan up to the Sturgeon Bay area.
• Travel: up to 60% throughout Sheboygan, WI and surrounding areas.
• Typical Work Days/Hours: Monday – Friday, 8:00 am – 4:30 pm CST

WAH Internet Statement

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.

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.

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.

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

Modern Hire

As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire 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.

SSN Alert

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website.

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
 About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our 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 veteran status. 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.