Care Manager, Telephonic Behavioral Health

About the role

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.

Fostering 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 thrives in part because every person can bring their whole self to work to do their best work. Our vibrant, diverse culture and environment of inclusion is one of our greatest strengths.

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

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$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.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.