Manager, Care Management

🔥 6 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $94.9k - $130.6k / 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, care coordinators and behavioral health professionals responsible for care management • Supervise, direct and evaluate health care professionals to ensure effective care coordination • Lead cross-functional collaboration through briefings and area meetings • Maintain communication with departmental managers to ensure alignment and operational efficiency • Identify members for case management and/or 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 and coordinate human resources tasks, software, hardware, supplies and support technologies • Monitor staff performance against service, utilization and care coordination benchmarks • Conduct field-based care team oversight visits and meetings with members, families, community partners and care teams • Travel approximately 25% and attend occasional onsite meetings at Humana Illinois locations • Manage up to 15 direct reports

🎯 Requirements

• Applicants must reside in Illinois in Cook County, within the listed ZIP codes or within a 10-mile radius of those ZIP codes • Active, unrestricted Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), or Licensed Clinical Professional Counselor (LCPC) license in Illinois • Five (5) or more years of professional experience working in the health care industry and/or in care management • Two (2) 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 • Advanced degree in nursing or business health field (preferred) • Certified Case Manager (CCM) (preferred) • Previous managed care experience (preferred) • Five (5) or more years of management/supervisor-level experience, including hiring, training, mentoring and coaching associates (preferred) • Experience with healthcare quality measures such as STARS and HEDIS and/or clinical program monitoring/evaluation (preferred) • Knowledge of community health and social service agencies and community resources (preferred) • Bilingual or multilingual ability, including English/Spanish, Arabic, Vietnamese, Amharic, Urdu or another language (preferred); must speak, read and write both languages without limitations and assistance • Valid state driver's license • Personal vehicle liability insurance meeting applicable minimum limits • Minimum home internet speeds of 25 Mbps download and 10 Mbps upload • Dedicated work space without ongoing interruptions to protect member PHI/HIPAA information • Willingness to complete TB screening • Willingness to complete the Interagency Language Rating (ILR) test if applicable

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Remote work arrangement • Flexible work schedule based on business needs