Manager, Care Management Behavioral Health

The Manager, Care Management Behavioral Health leads teams of nurses and behavioral health professionals responsible for care management. The Manager, Behavioral Health 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.

Report to the Regional CM Associate Director.

Position Responsibilities

• Oversees the assessment and evaluation of members' behavioral health needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
• Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
• Works cross departmentally and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
• Contributes to decisions about process and methodology for Intensive Case Management and Behavioral Health and responsible for deployment of program.
• Identifies and resolves barriers that hinder effective care.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Must be comfortable, experienced leading a hybrid/remote team.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Required Qualifications

• Unrestricted Registered Nurse (RN) license in the state of South Carolina
• Bachelor's degree in Nursing (BSN)or a Licensed Master Level Clinician in the field of psychology or social work (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT)
• 5+ years of Behavioral Health professional experience
• 2+ years of management experience
• 2+ years Care Coordination/Case Management experience
• Proficiency in analyzing and interpreting data trends
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
• Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits

Preferred Qualifications

• Previous experience working in a managed care field
• 5+ years of management/supervisor level experience
• 3+ years of clinical acute care experience in a behavioral health setting
• Certified Case Manager (CCM)
• Utilization management experience

Additional Information

Workstyle: This is a remote position

Location: South Carolina

Schedule: Monday - Friday from 8-5pm

Travel: Occasional travel as business needs

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

$78,400 - $107,800 per year

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