Senior Care Manager - Behavioral Health

About the Role

Employment Type: Full time

Become a part of our caring community and help us put health first. The Senior Care Manager, Telephonic Behavioral Health, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and well-being of members.

Key Responsibilities

• Serves as state Guardianship Liaison for Humana Healthy Horizons in KY MCD plan.
• The Senior Care Manager, Telephonic Behavioral Health work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
• Employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.
• Identifies and resolves barriers that hinder effective care.
• Ensures the patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.
• Role manages associate caseload for BH referrals.
• Facilitation of Integrated Clinical Rounds (prepare members for discussion, lead meeting, provide follow-up notes).
• Role has 100% oversight of our KY MCD guardianship membership.
• All members under state guardianship will be followed in some level of care management to ensure monitoring of ongoing care coordination and access to needed social, community, medical, and Behavioral Health Services.
• Complete a monthly report of Adult Guardianship Cases, which goes to our BH Director and ultimately KDMS.
• Attend in-person quarterly meetings at Humana corporate in Louisville, Ky.

Use your skills to make an impact.

Required Qualifications

• Must reside in Kentucky or a bordering state.
• Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline.
• 3+ years of experience working as a licensed Social Worker.
• Licensure in field of study within the state the individual will be required to practice.
• 1 year of managed care experience.

Preferred Qualifications

• Bilingual.
• Experience managing members under state guardianship.
• CCM certification.
• Knowledge of KY Medicaid state contract, community health and social service agencies, and additional community resources.

Additional Information

Work at Home Internet Statement To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular, and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Modern Hire Statement As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and i