Manager, Care Management

🔥 7 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 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 the care coordination team • Onboard new associates, including human resources tasks and ordering software, hardware, supplies, and support technologies • Monitor staff performance against service and utilization and care coordination benchmarks

🎯 Requirements

• Active, unrestricted RN license in the state of Illinois • Five (5) or more years of professional experience working in the health care industry and/or in care management • Three (3) or more years of leadership experience • Two (2) years of experience with care management, direct care, or leadership of children, NICU, or PICU populations • Ability to use electronic information applications/software programs, including electronic medical records • Proficiency in analyzing and interpreting data trends • Ability to travel throughout the state of Illinois • Patient-facing role requiring TB screening • Valid state driver's license • Personal vehicle liability insurance meeting residing-state minimum limits or Humana's stated limits, whichever is higher • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information • Preferred: advanced degree in nursing, social services, psychology, or business health field • Preferred: experience with children, adolescents, and foster care populations • Preferred: previous managed care experience • Preferred: five (5) or more years of management/supervisor experience including hiring, training, mentoring, and coaching • Preferred: healthcare quality measures experience, including STARS and HEDIS • Preferred: knowledge of community health and social service agencies and community resources • Preferred: bilingual or multilingual ability; must speak, read, and write both languages without limitations or assistance

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • 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 • Occasional travel to Humana's offices for training or meetings • Self-provided home internet service meeting minimum speeds of 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions