Remote Care Management Leader (RN/SW)

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

Job summary

Humana is seeking a Manager of Care Management to lead a multidisciplinary team serving Medicaid members in Illinois. The role centers on assessing member needs, guiding care decisions, and coordinating with partners to optimize wellness and resource use. Travel and field oversight are required to ensure program effectiveness.

You will drive data-informed improvements, maintain compliance, and mentor up to 15 support staff while aligning care processes with enterprise objectives.

Qualifications

• Must reside in Illinois
• Associate degree required
• Active RN or SW license
• 5+ years professional experience
• 2+ years management or supervisory experience
• Proficiency in analyzing data trends
• Progressive operational leadership experience
• Strong communication, analytical, problem solving and teamwork skills
• Knowledge of Medicaid/Medicare and long-term care policies
• Experience with Windows, Outlook, Excel, Word and MIS software
• Understanding care management models and extenders to address social needs
• Ability to lead cross-functional initiatives with external partners
• Ability to work independently and in a team

Responsibilities

• Oversee assessment and evaluation of members' needs to achieve wellness.
• Guide members and families toward appropriate resources for care.
• Collaborate with internal teams and external partners for care planning.
• Promote culturally responsive and trauma-informed care across activities.
• Monitor program performance and use data to drive improvement.
• Align processes to control cost and improve efficiency for existing products.
• Coordinate support to operations for cost-efficient, quality delivery.
• Ensure compliance with federal, state, and contractual requirements.
• Contribute to policy/procedure development for consistent service delivery.
• Support training and capacity-building for care management extenders.
• Represent the care management program in advisory groups and community forums.
• Participate in Humana's Compliance Program and privacy/security laws.

Skills

RN license

SW license

Data analysis

Leadership

Communication skills

Microsoft Excel

Education

Associate's Degree

Tools

Microsoft Office

Job description

Humana is seeking a Manager of Care Management to lead a multidisciplinary team serving Medicaid members in Illinois. The role centers on assessing member needs, guiding care decisions, and coordinating with partners to optimize wellness and resource use. Travel and field oversight are required to ensure program effectiveness.

You will drive data-informed improvements, maintain compliance, and mentor up to 15 support staff while aligning care processes with enterprise objectives.