Care Manager - Behavioral Health

Become a part of our caring community

At Humana, caring is everything. You look after our members and patients. We look after you. If caring means something to you too, we've got a spot for you. We design competitive and flexible benefits packages to provide our employees a sense of financial security now and in the future. Encouraging a culture of inclusion is part of the fabric of who we are. We must have a workplace that reflects the people we serve and grows in part because every person can bring their whole self to work to make an impact. Our vibrant, diverse culture and environment of inclusion is one of our greatest strengths. About Humana Healthy Horizons Humana Healthy Horizons is more than a health plan. We're human care. Humana Healthy Horizons focuses on helping people achieve their best health. Our dedicated strategies across various markets and states enable partnerships with state and local governments, community-based organizations, and national partners that commit to removing barriers to helping people achieve their best health. The individual in this role will work as an Oklahoma-based, primarily telephonic care manager, assessing and evaluating enrollees' needs and requirements to achieve or maintain optimal wellness by guiding enrollees/families towards and facilitating interaction with appropriate resources for their care and wellbeing. The individual in this role will work in collaboration with the interdisciplinary care management team. This team includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. The Care Manager, Telephonic Behavioral Health Nurse work assignments are varied but will focus on those enrollees with primarily behavioral health needs. The Care Manager, Behavioral Telephonic Nurse will utilize clinical expertise and experience to determine when face-to-face enrollee support is required. The Care Manager will engage the appropriate members of the care management team and/or coordinate in-person meetings between the care manager and the enrollee. This team-based approach is designed to ensure enrollees receive holistic person-centered care. Work assignments for this role are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Position Responsibilities

• Perform telephonic and face-to-face assessments and evaluations of the member's needs and requirements. These assessments aim to achieve and/or maintain an optimal wellness state. The goal is achieved by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member.
• Ensure member is progressing towards desired outcomes by monitoring care through assessments and/or evaluations.
• Create member care plans. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Employ a variety of strategies, approaches, and techniques to manage an Enrollee's behavioral, physical, environmental, and psycho-social health needs.
• Ensure Enrollees are progressing toward desired outcomes by monitoring their assessments and evaluations.
• Identify and resolve barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
• Follow established guidelines/procedures.
• Collaborate with providers and community services to promote quality and cost-effective outcomes.

Required Qualifications

• Must Reside in Oklahoma
• Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker (LCSW, LPC, LMFT)
• Minimum 1-year Behavioral Health clinical experience
• 2 or more years of experience of in-home case or care management
• Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
• Knowledge of community health and social service agencies and additional community resources
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
• Periodic travel to Humana Oklahoma City office for meetings and training

Preferred Qualifications

• Case Management Certification (CCM)

Additional Information

Travel

Must have a Valid driver's license with reliable transportation and the ability to travel within the state, as required

This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

Screening Requirements

This role is considered member facing and is part of Humana Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

40

$59,300 - $80,900 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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