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The Residential Adult Family Home Certifier cultivates the organization's social community through community advocacy programs and active engagement with community members. The Residential Adult Family Home Certifier is responsible for the certification of new and existing adult family homes in iCare/Humana network in accordance with the Medicaid Standards for Certified 1-2 Bed Adult Family Homes. This role travels throughout Southeastern WI.In this role you will:
- Sustain positive working relationships with internal stakeholders and provide excellent customer service to certified 1-2 bed Adult Family Home (AFH) providers to support the vision for residential transformation.
- Ensure compliance with the Medicaid Standards for Certified 1-2 Bed Adult Family Homes during the certification and recertification of assigned AFH’s. Screen provider documentation to ascertain eligibility to become certified.
- Independently complete Adult Family Home certification process for all new homes in assigned region of the network.
- Annually re-certify all certified AFH’s in assigned service region, maintaining timely and thorough completion of all necessary documentation.
- Verify and document the correction of all cited areas of non-compliances or areas of the standards that must come into compliance before a certification is issued.
- Maintain expert knowledge of the Medicaid Standards for Certified 1-2 Bed Adult Family Homes and DHS contract language pertaining to certified AFH expectations for providers and MCO staff.
- Coordinate and lead efforts around any provider plans of correction. Actively involved in any provider terminations or revocation of certification.
- Ensure a robust network of certified adult family homes that increases community connections, supports member choice and dignity, and fosters full participation in communities.
- Participate in on-going training; maintaining up to date knowledge to ensure compliance with Medicaid Standards and organizational policies and practices.
- Must travel within assigned region, and possibly state-wide at times to complete certifications and recertification's. Ability to visit homes on an emergent basis as appropriate.
Use your skills to make an impact
Required Qualifications
- Bachelor's degree
- Comprehension of the Home and Community-Based Settings Requirements
- Knowledge and understanding of the Community Based Settings requirements for Residential Providers
- 1-2 years of related experience that includes demonstrated knowledge and understanding of Family Care/Family Care Partnership
- Must reside within the State of WI or upper Illinois, preferably within the service coverage area (Southeastern WI)
Preferred Qualifications
- Knowledge of Medicaid standards for 1-2 bed Adult Family Homes and all related and reference standards.
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: SE Wisconsin- Madison down to Milwaukee areas
- Travel: up to 50-60% throughout coverage area
- Hours: Monday through 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 reed; wireless required, 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
HireVue
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.$58,700 - $70,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.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
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 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.
