Remote Manager Data Management

Humana; Springfield (IL); Remote; USD 95,000 - 125,000; Full time

Job summary

Humana in Springfield, IL seeks a Manager of Care Management to lead a team of nurses, care coordinators and behavioral health professionals. You will oversee care coordination activities, discharge planning and post-discharge follow-up, ensuring alignment with state contracts and performance metrics.

The role emphasizes strong leadership, data trend analysis, and collaboration across departments to improve patient outcomes while managing resources and projects within defined guidelines.

Qualifications

• Active Illinois RN/LCSW/LCPC license required.
• 5+ years in health care or care management.
• 2+ years in leadership roles.
• Proficiency with electronic information applications and EMRs.

Responsibilities

• Supervise and evaluate a diverse care coordination team.
• Lead cross-functional collaborations and align with managers.
• Monitor case management activities and discharge planning.
• Develop reporting tools to track performance metrics.

Skills

Leadership

Data analysis

EMR experience

Tools

EMR software

Job description

Manager, Care Management

Become a part of our caring communityHumana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health professionals responsible for care management. The Manager, Care Management, works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.

The Manager, Care Management supervises, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordination activities.Leads cross-functional collaboration through regular briefings and area meetings; maintains ongoing communication with departmental managers to ensure alignment and operational efficiency.Identify members for specific case management and / or disease management activities.Monitors case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions.Develop system-view recommendations, reports trends and implement appropriate actions to control trends.Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met.Develop reporting tools in collaboration with leadership to identify clinical performance.Interviews, hires, mentors, evaluates, coaches and manage performance for a diverse care coordination team.Onboards new associates including but not limited all pre-employment human resource tasks, ordering software, hardware, supplies and support technologies.Monitors performance of staff including service performance and adherence to established utilization and care coordination benchmarks.

Use your skills to make an impact

Required Qualifications

• Applicants must reside in the state of Illinois in Cook County, IL, within one of the following ZIP codes, or within a 10-mile radius of these Zip Codes: 60068, 60131, 60171, 60176, 60613, 60614, 60618, 60625, 60626, 60630, 60631, 60633, 60634, 60639, 60640, 60641, 60645, 60646, 60647, 60657, 60659, 60660, 60706, 60707, 60712, 60104, 60130, 60141, 60153, 60155, 60160, 60163, 60164, 60165, 60301, 60302, 60303, 60304, 60402, 60424, 60475, 60513, 60534, 60546, 60601, 60605, 60606, 60607, 60608, 60609, 60610, 60611, 60612, 60615, 60616, 60622, 60623, 60624, 60632, 60642, 60644, 60651, 60653, 60654, 60661, 60680, 60690, 60699, 60804, 60305
• An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois.
• Five (5) or more years of professional experience working in the health care industry and/or in care management.
• Two (2) or more years of leadership experience.
• Ability to use a variety of electronic information applications/software programs, including electronic medical records.
• Proficiency in analyzing and interpreting data trends.
• Ability to travel throughout the state of Illinois.

Preferred Qualifications

• Advanced degree in nursing or business health field.
• Certified Case Manager (CCM).
• Previous experience working in a managed care field.
• Five (5) or more years of previous management/supervisor