Humana

Telephonic Behavior Health Care Manager

San Antonio, Texas, United States

Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Behavioral HealthIndustries

Requirements

Candidates must possess a Bachelor’s degree in social work or a behavioral health-related field, with a minimum of 3-5 years of experience in social work or a related behavioral health setting, including at least 1 year of experience working with the pediatric population (under 21). A minimum of 1 year of case management experience is required, and an ACHA Level II Background Check is necessary. Preferred qualifications include a Master’s degree in a behavioral-health field and licensure as an LMHC, LMFT, or LCSW.

Responsibilities

The Telephonic Behavioral Health Care Manager will assess and evaluate members’ needs and requirements to achieve optimal wellness, guide members and families towards appropriate resources, and facilitate interaction with those resources. They will monitor utilization, conduct outreach based on acuity, participate in interagency planning meetings, refer to Humana’s Value Added Benefits, and collaborate with various external parties such as ABA providers, BH vendors, schools, and government agencies to coordinate care and address gaps in service. The role also involves managing the care of pediatric members receiving ABA services and addressing complaints and grievances related to member care.”} id=

Skills

Social Work
Behavioral Health
Case Management
Pediatric Care
ABA (Applied Behavioral Analysis)
Interagency Collaboration
Treatment Planning
Utilization Monitoring

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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