Remote Manager, Care Management (Medicaid)

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

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Travel reimbursements

Job summary

Humana is seeking a Manager of Care Management in Illinois to lead teams of nurses, social workers, and care managers. You will guide member care, coordinate with community partners, and ensure compliance with regulatory standards.

The role requires Illinois residency, RN or SW licensure, and 5+ years of experience with 2+ years in management. Travel is required and remote work is offered with frequent field visits.

Qualifications

• Must reside in Illinois.
• Minimum of an Associate's Degree.
• Active RN license or Social Work license.
• 5+ years of professional experience.
• 2+ years of management or supervisory experience.
• Proficiency in analyzing and interpreting data trends.
• Progressive operational leadership experience.
• Strong communication, analytical, problem solving and teamwork skills.
• Knowledge of Medicaid/Medicare and long-term care policies.
• Computer skills in Windows, Outlook, Excel, Word and MIS software.

Responsibilities

• Oversee assessment and evaluation of members' needs to achieve optimal wellness.
• Guide members and families toward appropriate resources for care.
• Collaborate with internal teams and external partners for care planning and delivery.
• Monitor program performance and drive continuous improvement.
• Ensure compliance with federal, state and contractual requirements.
• Develop policies and procedures to support high-quality service delivery.

Skills

RN license or SW license

5+ years experience

2+ years management

data analysis

cross-functional leadership

communication skills

Medicaid/Medicare knowledge

Microsoft Windows/Outlook/Excel/Word

collaboration with external partners

independence & teamwork

Education

Associate's Degree

Bachelor's degree (preferred)

Tools

MIS software

Excel

Office suite

Job description

Humana is seeking a Manager of Care Management in Illinois to lead teams of nurses, social workers, and care managers. You will guide member care, coordinate with community partners, and ensure compliance with regulatory standards.

The role requires Illinois residency, RN or SW licensure, and 5+ years of experience with 2+ years in management. Travel is required and remote work is offered with frequent field visits.