Humana

Care Management Behavioral Health Professional

Florida, United States

Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

Candidates must possess a Bachelor’s degree in nursing, social work, or a behavioral health related field, or have at least 3 years of experience working with individuals receiving Applied Behavioral Analysis (ABA) services. A Registered Behavior Technician (RBT) certification with 2+ years of experience is required, and an AHCA Level II Background Check must be completed.

Responsibilities

The Care Management Behavioral Health Professional will work with members in the case management program, engaging them in ABA services and screening for social determinants of health (SDOH), medical, and other identified needs to close care gaps. They will outreach to members and guardians, attend case conferences with treatment providers, and collaborate with members and families to ensure all gaps related to ABA and member needs are addressed. This role involves providing community resources, monitoring patient care through assessments and evaluations, and potentially creating member care plans, as well as addressing barriers that hinder effective care and ensuring patient progression towards desired outcomes.

Skills

Behavioral Health
Case Management
ABA (Applied Behavioral Analysis)
Social Determinants of Health (SDOH)
Community Resources
Care Planning
Assessment and Evaluation
Barrier Resolution
Psycho-social Health Management
Coordination with Treatment Providers
Screening and Outreach
Testing (Speech/OT/PT, Psychological, Neuropsychological)

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.

Key Metrics

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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