Humana

Care Management Support (CM) Manager- WI Medicaid

Wisconsin, United States

Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, HealthcareIndustries

Care Management Support Manager

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. The Care Management Support Manager serves as an essential partner in orchestrating iCare/Humana care management operations. In this role, you’ll provide valuable non-clinical assistance in identifying and evaluating the needs of our members, empowering them to reach and sustain their best possible wellness. By guiding members and their families to the right resources and fostering meaningful connections, you help make a real difference in their care journeys.

Responsibilities

  • Provide daily oversight and supervision of Care Management associates, including regular one-on-one meetings to review performance, deliver constructive feedback, and offer coaching to support professional development and ensure high-quality member support.
  • Collaborate cross-functionally with departments and teams across the organization to align care management strategies, enhance member outcomes, and support organizational goals and initiatives.
  • Provide support for auditing and monitoring of processes.
  • Facilitate effective collaboration within the Interdisciplinary Care Team (ICT), ensuring seamless coordination and timely referrals to Registered Nurse Case Managers (RNCMs) and Community Health Workers (CHWs) for enhanced member engagement and comprehensive care planning.
  • Assist in the development of policies and procedures to improve and standardize services to members.
  • Oversee the Maternal Health Program to ensure high-quality support for members through targeted interventions, while maintaining full compliance with contractual requirements and regulatory standards.

Required Qualifications

  • Bachelor’s degree in human services or a related field OR Associate degree in nursing.
  • 2 or more years of leadership experience.
  • 3 or more years of Care Management experience.
  • Proficient in Microsoft applications.
  • Reside within the State of WI.

Preferred Qualifications

  • Master's Degree in a related field.
  • 5+ years of Care Management experience.
  • Familiarity with Power BI.
  • Applicable State licensure in field of study.

Additional Information

Workstyle: HOME - Associates' home office environment is their primary work location, but they will use Humana office space on an as-needed basis for collaboration and other face-to-face needs.

Work Location: Must reside in Wisconsin.

Travel: Potential travel to the Humana/iCare office location in Milwaukee for in-person team meetings as needed. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Typical Work Days/Hours: Monday – Friday, 8:30 am – 5:00 pm CST

WAH Internet Requirements:

  • Minimum download speed of 25 Mbps and an upload speed of 10 Mbps is required.
  • Wireless, wired cable, or DSL connection is suggested.
  • Satellite, cellular, and microwave connections can be used only if approved by leadership.
  • Humana will provide telephone equipment appropriate to meet business requirements.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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 and experience.

Skills

Care Management
Medicaid
Supervision
Performance Review
Coaching
Cross-functional Collaboration
Auditing
Policy Development
Maternal Health Program Management
Compliance

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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