Associate Director, Care Management

Illinois, United States

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Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Managed CareIndustries

Requirements

Candidates must reside in Illinois, Indiana, or Wisconsin and possess an active, unrestricted Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), or Licensed Clinical Professional Counselor (LCPC) license in Illinois. A minimum of six years of experience in the healthcare or managed care industry is required, with at least three years specifically in care management for elderly or special needs high-risk populations. Two or more years of management or supervisory experience are necessary, along with comprehensive knowledge of Microsoft Office applications (Word, Excel, PowerPoint) and proficiency in data trend analysis. Progressive business consulting and/or operational leadership experience is also required. Travel up to 25% within Illinois to provider offices, government agencies, and Humana locations is expected.

Responsibilities

The Associate Director of Care Management will lead teams of nurses and behavioral health professionals responsible for care management, overseeing the assessment and evaluation of member needs to optimize wellness. Responsibilities include guiding the development, implementation, and evaluation of care management programs, and monitoring data sharing for service integration and continuity of care. This role involves facilitating communication with internal and external stakeholders, leading the preparation of program reports using data analytics, and championing process improvement initiatives to enhance care management practices and outcomes.

Skills

Care Management

Team Leadership

Registered Nurse (RN)

Licensed Clinical Social Worker (LCSW)

Licensed Clinical Professional Counselor (LCPC)

Managed Care

Data Analytics

Process Improvement

Stakeholder Communication

Regulatory Requirements

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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