Care Management Support Prof

San Antonio, Texas, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health InsuranceIndustries

Requirements

Candidates must possess an MSW from a CSWE accredited school and have at least 2 years of experience with Microsoft Office Suite (Word, Excel, Outlook), including troubleshooting technical difficulties. A minimum of 2 years of experience supporting members with social determinants of health (SDOH) needs, navigating community or healthcare resources, and working with individuals facing SDOH challenges is required. Exceptional communication and interpersonal skills, the ability to multitask in a fast-paced environment, and demonstrated cultural and demographic diversity understanding are essential. Preferred qualifications include experience with Special Needs Plans (SNP) in Medicare/Medicaid, medical social work, managing members with co-occurring medical and behavioral health conditions, advocating for managed care members, non-clinical case management, call center experience, and remote work experience. Applicants must have a dedicated, private home office with a locked door and hardwired high-speed internet access (minimum 25 Mbps downstream/10 Mbps upstream).

Responsibilities

The Care Management Support Professional will administer care management in coordination with RNs, Social Workers, and non-clinical associates. Key duties include leveraging knowledge of social determinants of health (SDOH) and community resources to identify, research, document, and coordinate services to support member well-being. This role involves serving as a knowledge resource for community services and information, providing education and coordination for member SDOH needs (e.g., transportation, food, housing), and collaborating with other Humana associates. The professional will also complete assessments as needed and contribute to improving consumer experiences.

Skills

Microsoft Word

Microsoft Excel

Microsoft Outlook

Technical Troubleshooting

Social Determinants of Health (SDOH)

Community Resources

Healthcare Resources

Communication

Interpersonal Skills

Rapport Building

Written Communication

Oral Communication

Multitasking

Fast-paced Environment

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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