Senior Care Manager - Behavioral Health

Kentucky, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Candidates must reside in Kentucky or a bordering state and possess a Master's degree in a behavioral-health field, such as social work or psychology. A minimum of 3 years of experience as a licensed Social Worker and licensure in the state of practice are required, along with 1 year of managed care experience. Bilingual skills and experience managing members under state guardianship are preferred.

Responsibilities

The Senior Care Manager will assess members' needs and guide them towards appropriate resources to achieve optimal wellness. This role serves as the state Guardianship Liaison for Humana Healthy Horizons in KY MCD plan, managing caseloads for BH referrals and facilitating Integrated Clinical Rounds. Responsibilities include overseeing KY MCD guardianship membership, monitoring care coordination, ensuring access to services, and completing monthly reports on Adult Guardianship Cases. Occasional travel to Humana offices for training or meetings may be required.

Skills

Behavioral Health

Care Management

Case Management

Assessment

Evaluation

Social Work

Psychology

Health Services

Communication

Problem-Solving

Reporting

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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