[Remote] Care Manager - Behavioral Health at Humana

Oklahoma, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health InsuranceIndustries

Requirements

Must reside in Oklahoma
Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker (LCSW, LPC, LMFT)
Minimum 1-year Behavioral Health clinical experience
2 or more years of experience in in-home case or care management

Responsibilities

Performs telephonic and face-to-face assessments and evaluations of the member’s needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member
Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations
Creates member care plans
Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas
Employs a variety of strategies, approaches, and techniques to manage an Enrollee’s behavioral, physical, environmental, and psycho-social health needs
Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations
Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes
Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed
Follows established guidelines/procedures
Collaborates with providers and community services to promote quality and cost-effective outcomes

Skills

Key technologies and capabilities for this role

Behavioral HealthTelephonic Care ManagementCare AssessmentClinical ExpertiseInterdisciplinary CollaborationSDOH CoordinationNursingWellness PlanningResource Facilitation

Questions & Answers

Common questions about this position

What is the work arrangement for this Care Manager role?

This is an Oklahoma-based position that is primarily telephonic, with some face-to-face assessments as needed.

What does the team structure look like for this position?

The role involves collaboration with an interdisciplinary care management team that includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants.

What is the company culture like at Humana?

Humana fosters a culture of inclusion where every person can bring their whole self to work, with a vibrant, diverse environment that reflects the people served and emphasizes caring.

What benefits does Humana offer?

Humana designs competitive and flexible benefits packages to provide employees a sense of financial security now and in the future.

What skills and experience are required for this Care Manager role?

The role requires clinical expertise in behavioral health nursing, ability to perform telephonic and face-to-face assessments, create care plans, monitor progress, and collaborate in a team-based approach for holistic person-centered care.

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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