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

Illinois, United States

Humana Logo
Not SpecifiedCompensation
N/AExperience Level
N/AJob Type
Not SpecifiedVisa
N/AIndustries

Requirements

  • Active Illinois licensed LCSW, LMFT or LCPC (No supervisees or provisional licenses)
  • Minimum of 2 years of post-degree clinical experience in behavioral health setting
  • Case management experience working with complex SMI, SUD, SED population
  • 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
  • Valid driver's license
  • Reside in Illinois

Responsibilities

  • Perform primarily face to face and telephonic assessments with members
  • Provide integrated care to ensure members receive timely, high-quality, and coordination services that meet their unique needs
  • Manage a member’s health issues and identify and resolve barriers that hinder effective care
  • 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
  • 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 (HRA)
  • 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
  • Proactively support transition of care efforts
  • Engaging in biannual and quarterly face-to-face visits, ensuring continuous monitoring and proactive intervention
  • 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
  • Other job duties as assigned

Skills

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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