Manager, Care Management

Humana; Illinois; Remote; USD 95,000 - 131,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana is seeking a Manager of Care Management to lead teams of nurses, care coordinators and behavioral health professionals in care management. The role will operate within guidelines, solving moderately complex problems and determining approach, resources, schedules and goals for projects within the department.

Requires IL licensure (RN, LCSW or LCPC), 5+ years in healthcare/care management, 2+ years leadership, and ability to travel across Illinois.

Qualifications

• Active IL RN, LCSW or LCPC licenses are required.
• 5+ years in healthcare/care management.
• 2+ years in leadership roles.
• Ability to travel within Illinois.
• Proficiency with electronic medical records and data interpretation.

Responsibilities

• Lead teams of nurses, care coordinators and behavioral health professionals in care management.
• Operate under established guidelines, determining approach, resources, schedules and goals.
• Travel throughout Illinois as needed to support field activities.
• Collaborate with cross-functional partners to improve care outcomes.

Skills

Leadership

Data analysis

Healthcare knowledge

Communication

Travel readiness

Education

IL RN license

LCSW or LCPC IL license

Tools

EMR systems

Job description

Become a part of our caring community

Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health professionals responsible for care management. The Manager, Care Management, works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.

Required Qualifications

• Applicants must reside in the state of Illinois in Cook County, IL, within one of the following ZIP codes, or within a 10-mile radius of these Zip Codes: 60068, 60131, 60171, 60176, 60613, 60614, 60618, 60625, 60626, 60630, 60631, 60633, 60634, 60639, 60640, 60641, 60645, 60646, 60647, 60657, 60659, 60660, 60706, 60707, 60712, 60104, 60130, 60141, 60153, 60155, 60160, 60163, 60164, 60165, 60301, 60302, 60303, 60304, 60402, 60424, 60475, 60513, 60534, 60546, 60601, 60605, 60606, 60607, 60608, 60609, 60610, 60611, 60612, 60615, 60616, 60622, 60623, 60624, 60632, 60642, 60644, 60651, 60653, 60654, 60661, 60680, 60690, 60699, 60804, 60305.
• An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of 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 a variety of electronic information applications/software programs including electronic medical records.
• Proficiency in analyzing and interpreting data trends.
• Ability to travel throughout the state of Illinois.

Preferred Qualifications

• Advanced degree in nursing or business health field.
• Certified Case Manager (CCM).
• Previous experience working in a managed care field.
• Five (5) or more years of previous management/supervisor level experience to include hiring, training, mentoring and coaching associates.
• Prior experience with healthcare quality measures STARS, HEDIS, etc. and/or clinical program monitoring/evaluation.
• Knowledge of community health and social service agencies and additional community resources.
• Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. See "Additional Information" section for language assessment information.

Additional Information

• Workstyle: This is a remote position that requires travel.
• Travel: 25% field-based interactions conducting care team oversight visits, meeting with members and/or their families, community partners and other care teams. May need to attend occasional onsite meetings in Humana's Illinois locations.
• Typical Workdays and Hours: Monday - Friday 8:00 AM - 5:00 PM CST. May need to be provide flexibility with work schedule based on business needs.
• Direct Reports: Up to 15 associates.
• Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

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

This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

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

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.

$94,900 - $130,600 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

About Humana: 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.