[Remote] Field Care Manager, Behavioral Health 2 at Humana

Virginia, United States

Apply Now

Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Behavioral HealthIndustries

Requirements

Bachelor’s degree in social work, psychology or other health or human services related field
Virginia licensed LMHP, LPC or LCSW
Minimum of 2 years of post-degree clinical experience in behavioral health setting
Case management experience working with complex SMI or SED population
Must reside in Roanoke/Alleghany region or Surrounding Areas
Ability to travel to region-based facilities and homes for face-to-face assessments
Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport
Ability to work with minimal supervision within the role and scope
Ability to use a variety of electronic information applications/software programs including electronic medical records
Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel
Ability to work a full-time schedule
Valid driver's license, car insurance, and reliable transportation
Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Responsibilities

Utilize high-quality, evidence-based behavioral health services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical and behavioral health providers
Provide comprehensive, integrated support to members experiencing behavioral health conditions, including children, adolescents, adults with serious mental illness (SMI) and serious emotional disturbance (SED), and justice-involved members
Engage members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination
Complete all required assessments, including the Comprehensive Risk Assessment (CHRA)
Coordinate behavioral health and medical services, ensuring appropriate provider engagement and adherence to treatment plans
Improve member’s health literacy while simultaneously addressing health related social needs to positively impact member’s healthcare outcomes and well-being
Serve as the quarterback of the member’s interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery
Facilitate ICT meetings, ensuring seamless communication among providers, Service Coordinators, and Care Management Extenders
Engage in biannual and quarterly face-to-face visits, ensuring continuous monitoring and proactive intervention
Work with autonomy but reach out when support is needed
Collaborate with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members’ preferences and needs
Follow processes and procedures to ensure compliance with regulatory requirements by the Virginia Department of Medical Assistance Services (DMAS), Center for Medicare and Medicaid Services (CMS) and the National Committee on Quality Assurance (NCQA)

Skills

Care Coordination

Crisis Intervention

Behavioral Health Assessments

Risk Assessment

Interdisciplinary Care Team

Health Literacy

Peer Support

Telephonic Assessments

Community Engagement

Medicaid Services

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.

Land your dream remote job 3x faster with AI

Try Jobo Free