Care Manager - Behavioral Health

Oklahoma, 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 Oklahoma and possess an active Registered Nurse (RN) license or a Licensed Master Level Social Worker (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT). A minimum of 1 year of behavioral health clinical experience is required, along with 2 or more years of experience in care management.

Responsibilities

The Care Manager will conduct telephonic and face-to-face assessments of member needs to achieve optimal wellness, guiding them toward appropriate resources. They will monitor member progress through continuous assessments, create care plans, and manage behavioral, physical, environmental, and psycho-social health needs. The role involves identifying and resolving barriers to effective care, collaborating with providers and community services for quality and cost-effective outcomes, and making independent decisions regarding work methods.

Skills

Behavioral Health

Care Management

Telephonic Communication

Clinical Expertise

Assessment

Resource Facilitation

Interdisciplinary Collaboration

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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