Care Manager, Telephonic Behavioral 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 2 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, engaging the appropriate members of the care management team and/or coordinating 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

• Performs telephonic and face to face assessments and evaluations of the member's needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member.
• Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations.
• Creates member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Employs a variety of strategies, approaches, and techniques to manage an Enrollee's behavioral, physical, environmental, and psycho-social health needs.
• Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations.
• Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
• Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed.
• Follows established guidelines/procedures.
• Collaborates 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.
• Exceptional communication and interpersonal skills with the ability to quickly build rapport.
• 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.

Scheduled Weekly Hours

40

Pay Range

$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.