Care Management Manager

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $86.3k - $118.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Lead teams of nurses, care coordinators, and behavioral health professionals responsible for care management, transitions of care, and child/adolescent populations • Supervise, direct, and evaluate diverse health care professionals to ensure effective care coordination • Lead cross-functional collaboration through regular briefings and area meetings • Maintain communication with departmental managers to ensure alignment and operational efficiency • Identify members for case management and disease management activities • Monitor case management activities, post-discharge calls, discharge planning, and pre-assessment of elective admissions • Develop system-view recommendations, report trends, and implement actions to control trends • Develop audit plans and tools to ensure compliance with state contracts and performance metrics • Develop reporting tools with leadership to identify clinical performance • Interview, hire, mentor, evaluate, coach, and manage performance for a diverse care coordination team • Onboard new associates, including pre-employment HR tasks and ordering software, hardware, supplies, and support technologies • Monitor staff performance against service performance and utilization and care coordination benchmarks • Travel throughout the state of Illinois up to 25%

🎯 Requirements

• Active, unrestricted Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) license in Illinois; license must be active within 6 months of hire • Experience with children, adolescents, and foster care populations • Five or more years of professional experience in the health care industry and/or care management • Two or more years of leadership experience • Ability to use electronic information applications/software programs, including electronic medical records • Proficiency in analyzing and interpreting data trends • Ability to travel throughout Illinois up to 25% • Valid state driver's license • Personal vehicle liability insurance meeting the residing state's minimum limits or specified Humana limits, whichever is higher • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Preferred: advanced degree in nursing, social services, psychology, or business health • Preferred: managed care experience • Preferred: five or more years of management/supervisor experience, including hiring, training, mentoring, and coaching • Preferred: experience with STARS, HEDIS, or other healthcare quality measures and clinical program monitoring/evaluation • Preferred: knowledge of community health, social service agencies, and community resources • Preferred: bilingual or multilingual ability, including English/Spanish, Arabic, Vietnamese, Amharic, Urdu, or another language; must speak, read, and write both languages without limitations or assistance • Patient-facing role requiring TB screening

🏖️ Benefits

• Bonus incentive plan • 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 • Self-provided internet service requirements for home or hybrid employees • Remote work from a dedicated space to protect member PHI/HIPAA information