Remote Care Management Leader (RN/SW)

Humana; Effingham (IL); On-site; USD 86,300 - 118,700; Full time

Benefits offered by this job

Mileage reimbursement

Health benefits

401(k)

Job summary

Humana seeks a Manager, Care Management to lead teams delivering Medicaid member care in Illinois. You will guide assessments, coordinate resources, and ensure compliant, high-quality service across the care management program.

Lead collaborations with community partners, monitor outcomes, and drive improvements while navigating social determinants of health. Expect remote work with 50–75% travel, and on-site Humana meetings as needed.

Qualifications

• Must reside in Illinois.
• Active RN or SW license.
• Minimum 5+ years of professional experience.
• 2+ years of management or supervisory experience.
• Ability to analyze data trends and lead operations.
• Knowledge of Medicaid/Medicare and long-term care guidelines.
• Proficient with Microsoft Windows, Outlook, Excel and MIS software.

Responsibilities

• Lead teams of nurses, social workers and care management staff.
• Oversee assessment and evaluation of members' needs.
• Ensure compliance with federal, state and contractual requirements.
• Collaborate with community partners and cross-functional teams.
• Monitor program performance and drive continuous improvement.
• Align processes with market objectives to control costs.
• Support training for care management extenders.

Skills

RN license

SW license

Data analysis

Leadership

Communication

Medicaid/Medicare knowledge

Microsoft Windows

Excel

Word

MIS software

Education

Associate's Degree

Bachelor's degree preferred

Tools

Microsoft Windows

Outlook

Excel

Word

MIS software

Job description

Humana seeks a Manager, Care Management to lead teams delivering Medicaid member care in Illinois. You will guide assessments, coordinate resources, and ensure compliant, high-quality service across the care management program.

Lead collaborations with community partners, monitor outcomes, and drive improvements while navigating social determinants of health. Expect remote work with 50–75% travel, and on-site Humana meetings as needed.