Remote Care Management Leader, Stars Initiative

Humana Inc; Santa Fe (NM); Remote; USD 86,000 - 119,000; Full time

Job summary

Humana Inc. is seeking a Manager, Care Management to lead a Stars-focused team delivering targeted telephonic outreach to close care gaps and connect members with needed resources.

Reporting to the Associate Director of Care Management, you will drive quality, accountability, and member-centered outcomes while guiding the team through evolving Stars priorities and business needs. This remote role emphasizes data-driven leadership and cross-enterprise collaboration.

Qualifications

• Active, unrestricted RN license with no disciplinary action.
• 5+ years of RN experience.
• 3+ years of experience in case management.
• 1+ years of data-driven leadership experience with analyzing performance and implementing improvements.
• Strong proficiency in Microsoft Office and ability to learn multiple software applications.

Responsibilities

• Provide leadership and coaching for associates conducting telephonic, Stars-focused outreach.
• Ensure needs beyond initial outreach are identified and referred to appropriate resources.
• Inspire an engaged, accountable team with clear behavioral standards and collaboration.
• Set and manage performance across outreach, care-gap closure, productivity, documentation and compliance.
• Translate Stars priorities into team actions and monitor results to improve engagement and outcomes.
• Collaborate with enterprise partner teams to identify opportunities and address barriers.
• Use data to identify trends, risks, and coaching needs and implement measurable actions.
• Serve as escalation resource for complex member needs and operational issues.
• Communicate leadership updates and present recommendations on performance and risks.
• Support onboarding, training, and ongoing education on Stars measures and referral processes.

Skills

RN license

Leadership

Case management

Data-driven leadership

Microsoft Office

Education

Bachelor’s degree in nursing

Master’s degree in nursing

Healthcare administration

Tools

Microsoft Office

Job description

Humana Inc. is seeking a Manager, Care Management to lead a Stars-focused team delivering targeted telephonic outreach to close care gaps and connect members with needed resources.

Reporting to the Associate Director of Care Management, you will drive quality, accountability, and member-centered outcomes while guiding the team through evolving Stars priorities and business needs. This remote role emphasizes data-driven leadership and cross-enterprise collaboration.