Become a part of our caring community and help us put health first

　　The Transition Coordinator contributes to the administration of continuity of care and transition among managed care organizations (MCOs) or other programs. The Transition Coordinator coordinates appropriate treatment, ensures continuity of care without lapse in services, and facilitates seamless transition for Enrollees among MCOs, programs, and services.

　　Develops policies and procedures to assure seamless transition of Enrollee care, including Provider service authorizations, care and treatment plans, and continuity of care processes.Oversees the assessment and evaluation of members' health 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.Works closely with the Oklahoma Health Care Authority (OHCA) and other MCOs to assure Enrollee care is transitioned without disruption in service.Assures processes are in place for secure and timely data and file exchange between MCOs and OHCA, including care plans, authorizations, and Enrollee records.Leads cross departmental collaboration and conducts briefings and area meetings.Maintains frequent contact with OHCA, entities involved in an Enrollee's care, and with internal department associates to assure well-coordinated transitions among healthcare settings, MCOs, and care Providers, to reduce unnecessary hospital admissions or readmissions, and to assure Enrollee access to quality healthcare.

　　Required Qualifications

　　Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker ((LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT)Bachelor's degree in nursing or related field 5+ years of professional experience2+ years of management experienceProficiency in analyzing and interpreting data trends.Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPointExperience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.

　　Preferred Qualifications

　　Previous experience working in a managed care field.Certification, Case Management

　　Additional Information

　　Workstyle: Hybrid; A combination of remote and Humana's Oklahoma City location.

　　Work at Home Criteria

　　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.

　　Interview Format

　　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.

　　Scheduled Weekly Hours

　　40

　　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.