Telephonic Behavioral Health Care Manager

Illinois, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Candidates must possess a Master's degree in a behavioral-health field such as social work or psychology from an accredited university. A Licensed Social Worker (LSW) or Licensed Clinical Social Worker (LCSW) in Illinois, or the ability to obtain IL licensure, is required, along with a minimum of 3 years of experience as a licensed social worker. Preferred qualifications include CCM certification, managed care experience, bilingual skills in English/Spanish, and experience with the geriatric population and community health resources.

Responsibilities

The Telephonic Behavioral Health Care Manager will telephonically connect with members facing complex medical and mental health challenges to provide support and guidance. Responsibilities include applying clinical knowledge to educate members, navigating the healthcare system, consulting with members to ensure quality care, and guiding them toward appropriate resources. The role involves coordinating community care, proactively outreach to eligible members for care management programs, conducting assessments for timely interventions, and recommending or coordinating interventions. Collaboration with an interdisciplinary team, compliance with performance standards, and utilization of motivational interviewing and solution-oriented approaches are also key duties.

Skills

Behavioral Health

Care Management

Telephonic Communication

Clinical Knowledge

Psychological Assessment

Emotional Assessment

Environmental Assessment

Motivational Interviewing

Solution-Oriented Approaches

Interdisciplinary Collaboration

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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