[Remote] Care Manager, Behavioral Health at Humana

Kentucky, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must reside in Kentucky or a contiguous border state and possess an active, unrestricted LCSW, LPCC, LMFT license in Kentucky, or another independent professional state license with at least 1 year of post-degree clinical behavioral health experience. Alternatively, an active, unrestricted Kentucky RN license with at least 3 years of behavioral health experience is required. Proficiency in Microsoft Office Suite, navigating multiple systems, and basic remote technical troubleshooting are necessary. Preferred qualifications include experience with KY Medicaid, SPMI/SUD patients, managed care, case management certification, and bilingual (English/Spanish) skills. A valid driver's license and personal vehicle liability insurance are mandatory.

Responsibilities

The Field Care Manager, Behavioral Health 2 will assess member needs and requirements to optimize wellness, guiding them towards appropriate resources. Responsibilities include coordinating with providers and community services for quality and cost-effective outcomes, employing various strategies to manage members' physical, environmental, and psychosocial health, and identifying/resolving barriers to effective care. The role involves continuously monitoring patient progress through assessments, potentially creating care plans, influencing department strategy, and maintaining knowledge of community resources. This remote position requires up to 10% travel for member visits and meetings.

Skills

Behavioral Health

Care Management

Health Needs Assessment

Community Resources

Social Determinants of Health

Patient Advocacy

Case Management

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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