Care Manager - Behavioral Health

Humana Inc; Oklahoma; Hybrid; USD 59,000 - 81,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off

Job summary

Humana Inc. is seeking an Oklahoma-based Care Manager, Telephonic Behavioral Health Nurse, working with the Humana Healthy Horizons team.

The role involves assessing enrollees, guiding families to appropriate resources, and coordinating with an interdisciplinary care management group for holistic, person-centered care. The position requires an RN license or related social work license, at least 1 year of behavioral health experience, and 2+ years in-home case management, with travel within the

Qualifications

• Must reside in Oklahoma.
• Active RN license or licensed social worker (LCSW/LPC/LMFT).
• Minimum 1 year behavioral health clinical experience.
• 2+ years in-home case or care management.
• Experience coordinating services for Medicaid/Medicare enrollees.
• Knowledge of community health and social services.
• Proficient in Microsoft Word, Excel, PowerPoint.

Responsibilities

• Perform telephonic and face-to-face assessments and evaluations of member needs to achieve optimal wellness.
• Create member care plans and monitor progress towards outcomes.
• Collaborate with care management team and providers for holistic care.
• Identify and resolve barriers hindering care and coordinate relevant resources.
• Follow established procedures and promote quality and cost-effective outcomes.

Skills

RN license

LCSW/LPC/LMFT

Behavioral health

Medicare/Medicaid experience

Microsoft Office

Tools

Microsoft Office

Job description

Become a part of our caring community At Humana, caring is everything. You look after our members and patients. We look after you. If caring means something to you too, we've got a spot for you. We design competitive and flexible benefits packages to provide our employees a sense of financial security now and in the future. Encouraging a culture of inclusion is part of the fabric of who we are. We must have a workplace that reflects the people we serve and grows in part because every person can bring their whole self to work to make an impact. Our vibrant, diverse culture and environment of inclusion is one of our greatest strengths.

About Humana Healthy Horizons

Humana Healthy Horizons is more than a health plan. We're human care. Humana Healthy Horizons focuses on helping people achieve their best health. Our dedicated strategies across various markets and states enable partnerships with state and local governments, community-based organizations, and national partners that commit to removing barriers to helping people achieve their best health.

The individual in this role will work as an Oklahoma-based, primarily telephonic care manager, assessing and evaluating enrollees' needs and requirements to achieve or maintain optimal wellness by guiding enrollees/families towards and facilitating interaction with appropriate resources for their care and wellbeing. The individual in this role will work in collaboration with the interdisciplinary care management team. This team includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. The Care Manager, Telephonic Behavioral Health Nurse work assignments are varied but will focus on those enrollees with primarily behavioral health needs. The Care Manager, Behavioral Telephonic Nurse will utilize clinical expertise and experience to determine when face-to-face enrollee support is required. The Care Manager will engage the appropriate members of the care management team and/or coordinate in-person meetings between the care manager and the enrollee. This team-based approach is designed to ensure enrollees receive holistic person-centered care. Work assignments for this role are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Position Responsibilities

Perform telephonic and face-to-face assessments and evaluations of the member's needs and requirements. These assessments aim to achieve and/or maintain an optimal wellness state. The goal is achieved by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member. Ensure member is progressing towards desired outcomes by monitoring care through assessments and/or evaluations. Create member care plans. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Employ a variety of strategies, approaches, and techniques to manage an Enrollee's behavioral, physical, environmental, and psycho-social health needs. Ensure Enrollees are progressing toward desired outcomes by monitoring their assessments and evaluations. Identify and resolve barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes. Follow established guidelines/procedures. Collaborate with providers and community services to promote quality and cost-effective outcomes. Use your skills to make an impact.

Required Qualifications

• Must Reside in Oklahoma
• Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker (LCSW, LPC, LMFT)
• Minimum 1-year Behavioral Health clinical experience
• 2 or more years of experience of in-home case or care management
• Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
• Knowledge of community health and social service agencies and additional community resources
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
• Periodic travel to Humana Oklahoma City office for meetings and training

Preferred Qualifications

• Case Management Certification (CCM)

Additional Information Travel

Must have a Valid driver's license with reliable transportation and the ability to travel within the state, as required. 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 100,000/300,000/100,000 limits.

Screening Requirements

This role is considered member facing and is part of Humana Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Work at Home Requirements

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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

40

Pay 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. $59,300 - $80,900 per year This 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, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.