[Remote] Behavioral Health Care Manager at Humana

Texas, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Current valid social service license (MSW, LCSW, LPC, LMHC)
Master's degree in a behavioral-health field (social work, counseling, or related health discipline)
2+ years of experience in an integrated care setting managing members with Behavioral Health needs and/or Substance Use
Experience with behavioral change, health promotion, coaching, and/or wellness
Proficiency in software programs (Word, Excel, PowerPoint, shared systems)
Ability to troubleshoot and resolve general technical issues
Bilingual (English/Spanish) (optional)
Experience working telephonically (optional)
Experience working in Community Mental Health or crisis response team (optional)
Experience working with both children and adults (optional)

Responsibilities

Assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state
Guide members/families toward and facilitate interaction with resources for care and well-being
Support members' access to behavioral health services
Provide member outreach and education related to behavioral health
Assess risk and determine appropriate care for individual patient communities
Collaborate with providers and clinicians across other Humana departments
Employ strategies, approaches, and techniques to manage members' physical, environmental, and psycho-social health issues
Identify and resolve barriers that hinder effective care
Continuously monitor member care through assessments and/or evaluations
Create member care plans
Understand department, segment, and organizational strategy and operating objectives
Make decisions regarding own work methods in ambiguous situations
Follow established guidelines/procedures
Schedule and manage work hours (8 hour shift between 8:00 AM and 6:00 PM in local time zone)

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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