Manager, Care Management – Behavioral Health

🔥 2 minutes ago

🌴 South Carolina – Remote

🌴 South Carolina – Remote

💵 $78.4k - $107.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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 and behavioral health professionals responsible for care management • Oversee assessment and evaluation of members’ behavioral health needs and requirements • Guide members and families toward appropriate care and wellbeing resources • Make decisions on resources, approaches, and tactical operations for departmental projects and initiatives • Work cross-departmentally and conduct briefings and area meetings • Maintain frequent contact with other department managers • Identify and resolve barriers hindering effective care • Apply department, segment, and organizational strategy and operating objectives • Determine work methods and manage assignments with minimal direction • Report to the Regional CM Associate Director • Contribute to continuously improving consumer experiences

🎯 Requirements

• Unrestricted Registered Nurse (RN) license in the state of South Carolina • Bachelor’s degree in Nursing (BSN) or a Licensed Master Level Clinician in psychology or social work (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT) • 5+ years of Behavioral Health professional experience • 2+ years of management experience • 2+ years of Care Coordination/Case Management experience • Proficiency in analyzing and interpreting data trends • Comprehensive knowledge of Microsoft Office applications, including Word, Excel and PowerPoint • Experience working with Medicaid and/or Medicare enrollees to coordinate services, care needs, or benefits • Experience with NCQA, including leading re-accreditation activities • Experience with NCQA, state audit, and external quality review (EQR) • Previous experience working in a managed care field • 5+ years of management/supervisor-level experience • 3+ years of clinical acute care experience in a behavioral health setting • Certified Case Manager (CCM) • Utilization management experience • Ability to work Monday–Friday, 8:00 a.m.–5:00 p.m. • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Home internet with at least 25 Mbps download and 10 Mbps upload speed

🏖️ Benefits

• 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 • Bonus incentive plan • Remote work • Occasional travel to Humana offices for training or meetings • Internet service requirements/support for home or hybrid employees