Care Manager - Physical 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, Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW). A minimum of 1 year of clinical experience and 2 or more years of care management experience are required, along with experience working with Medicaid and/or Medicare Enrollees. Knowledge of community health and social service agencies and additional community resources is also necessary.

Responsibilities

The Care Manager will conduct telephonic and face-to-face assessments to evaluate enrollees' physical, behavioral, environmental, and psycho-social health needs, guiding them towards appropriate resources. Responsibilities include monitoring enrollee progress, identifying and resolving barriers to care, creating care plans, and collaborating with providers and community services to achieve quality and cost-effective outcomes. The role involves working within an interdisciplinary care management team and potentially traveling to the Humana Oklahoma office for meetings and training.

Skills

Care Management

Physical Health

Telephonic Communication

Clinical Expertise

Holistic Care

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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