Manager, Clinical Care Integration

humana; West Palm Beach (FL); Hybrid; USD 110,000 - 150,000; Full time

Job summary

Humana is seeking a Care Integration Team Manager to lead a multidisciplinary team of nurses, care coaches, and social workers. This role oversees care management delivery, team performance, staff development, and patient engagement to improve health outcomes.

The hybrid position requires travel to local clinics and communities, direct patient management for a portion of time, and collaboration with clinical and operational leaders to reduce avoidable care utilization.

Qualifications

• Active nursing license (RN, LPN, or equivalent) or related medical credential.
• 5+ years of nursing, case management, or disease management experience.
• 2+ years of leadership experience.
• Experience with transitions of care and senior populations.
• Strong knowledge of chronic conditions and disease management interventions.

Responsibilities

• Lead daily operations of the Care Integration Team, including productivity and performance management.
• Ensure program goals and quality metrics are met across teams.
• Recruit, onboard, train, and develop staff.
• Manage high-risk patient caseloads and care planning.
• Build partnerships with market leaders and stakeholders to improve outcomes.

Skills

RN license

Leadership

Data analysis

Clinical knowledge

MS Office

Driving

Education

Nursing or medical license required

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 also maintains a direct caseload of high-risk patients while balancing leadership, operational, and strategic responsibilities. 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 hybrid 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 direct patient 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.


• Manages a caseload of high risk patients including performance of transitional and longitudinal care management, care planning, multidisciplinary case rounds, and patient home visits. 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.


• Fosters a high-performing, engaged team culture that supports accountability, retention, professional growth, and recognition of achievements. Ensures team members understand how their work contributes to program goals.

Use your skills to make an impact

Req uired Qualifications

• A n active R egistered Nurse , or L icensed Practice Nurse or Licensed Vocational Nurse, or PharmD licens ure , or E mergency M edical T echnician certification , or foreign equivalent of Registered Nurse or Medical Doctor license


• 5+ years of prior nursing , case management, or disease management experi e nce


• 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 healt