Manager, Clinical Care Integration

humana; The Villages (FL); On-site; USD 95,000 - 135,000; Full time

Job summary

Humana seeks a Care Integration Team Manager to lead a multidisciplinary team delivering high-needs patient care through an interdisciplinary approach. The role focuses on program delivery, staff development, and operational excellence, with regional travel to clinics and community sites.

The manager will partner with market leaders to improve outcomes and reduce avoidable utilization, while guiding performance metrics and coaching to ensure high-quality patient care.

Qualifications

• Active Registered Nurse with current licensure.
• 5+ years of nursing experience and 2+ years of leadership.
• Experience with transitions of care and senior populations.
• Strong data analysis skills and ability to interpret trends.
• Proficiency with Microsoft Office suite.
• Willingness to travel to clinics and community sites.

Responsibilities

• Lead daily operations of the Care Integration Team, including staffing and performance management.
• Ensure program goals across productivity, quality, engagement, and utilization.
• Set clear expectations, provide feedback, and implement improvement plans.
• Maintain clinical program integrity and escalate issues to leadership as needed.
• Hire, onboard, train, and retain Care Integration Team staff.
• Review patient cases, assess drivers of utilization, and inform care plans.
• Partner with market leaders and stakeholders to improve operations and outcomes.
• Build and maintain community partnerships with health systems and care providers.

Skills

Active RN

Nursing leadership

Care transitions

Data analysis

Microsoft Office

Travel to clinics

Tools

Microsoft Office

Job description

Become a part of our caring community

The Care Integration Team Manager is responsible for managing a team of nurses, care coaches, and social workers (referred to as "Care Integration Team or CIT) who engage high needs patients using an interdisciplinary team-based approach to ensure patients receive the individualized care and services they need to reach optimal health. The Manager provides direct oversight of market-based Care Integration Team operations, including care management program execution, team performance, staff development, and patient engagement. The Manager is responsible for building strong partnerships with clinical and operational market leaders on the Care Integration Team program and strategic opportunities for managing populations and coordinating care to improve patient outcomes and reduce avoidable acute and post-acute care utilization.

The Manager role is in office with travel requirements to local clinics and communities (e.g., for market leader meetings, in-clinic case rounds, team member shadowing/coaching, home visit ride-along) and to preferred healthcare facilities in the community, alongside clinical market leader, to develop clinical partnerships for timely access to patient information, clinical collaboration on patient care, and patient centered resources.

As a guideline, this role involves spending 20% of the time on quality management, 70% of time on team management, operational excellence and program delivery, quality oversight, and staff development, and 10% of time on market relationships and community partnerships.

Major Duties and Responsibilities

• Leads daily operations of the Care Integration Team, including productivity, quality, recruiting/hiring, training, and performance management.
• Accountable for market Care Integration Team's achievement of program goals and expectations across productivity, adherence to standard processes, clinical quality, patient engagement, utilization, and financial measures. Monitors and guides team performance using performance dashboards and metrics. Develops and implements action plans to meet goals.
• Establishes clear performance expectations and holds Associates accountable through regular 1:1 feedback, audits / shadowing, SMART goals, coaching, and corrective action plans when needed. Builds team member capabilities through individual and group-based feedback and training sessions. Recognizes and celebrates strong performance.
• Ensures clinical program integrity at the market level and addresses improvement opportunities, escalating to Clinical Care Integration Director as appropriate.
• Interviews, hires, onboards, trains, and retains Care Integration Team associates.
• Supports team members in reviewing patient cases, assessing drivers of utilization, and developing care plan recommendations for PCP review.
• Partners with market leaders and key stakeholders to review performance and develop action plans to improve operational performance and reduce avoidable acute and post-acute care utilization. Prepares and leads regular market leader performance review meetings. Promotes collaboration and a "one care team" approach to optimize management of high-needs patients.
• Builds and maintains relationships with community partners, including community health organizations, Centerwell organizations (home health and pharmacy), and health care systems for strong clinical collaboration to improve patient experience and population health outcomes.

Use your skills to make an impact

Required Qualifications

• Active Registered Nurse
• 5+ years of prior nursing experience
• 2+ years of leadership experience
• Experience with transitions of care management and working with senior populations
• Excellent clinical competencies, including knowledge of chronic conditions (e.g., Diabetes, CHF, COPD, CKD) and related symptoms, risk factors / signs of exacerbations, disease management interventions, and common medications
• Experience working in primary care value-based / managed care organizations
• Proficiency in analyzing and interpreting data trends
• Comprehensive knowledge in Microsoft office products
• Driving required to clinics and community organizations and health systems

Characteristics of the qualified candidate:

• Pro-active, positive attitude, and comfortable being a change agent
• Capable of identifying root causes of operational issues, problem-solving, and developing action plans
• Capable of setting SMART goals, aligned with organization, and holding staff accountable for achieving goals.
• Excellent communication skills, including follow-through communication and the ability to interpret and translate data to tell a story via executive level presentations.
• A passionate advocate for improving clinician and patient experience and health outcomes through population health management.
• Relationship management and negotiation skills to ensure key organizational and community partners feel engaged, heard, and respected.
• Skilled at leading meetings with Medical and