Telephonic Behavioral Health Care Manager

San Antonio, Texas, 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 current, valid, and unrestricted license as a Mental Health/Behavioral Health Professional, such as LCSW, LPC, LMHC, LMSW, or Ph.D. in their state of residency. A minimum of 3 years of clinical or managed care experience is required, along with experience in mental health crisis intervention. Proficiency in Microsoft Office Suite (Word, Excel, OneNote, Outlook), excellent written and verbal communication, organizational skills, and the ability to handle calls professionally are essential. Applicants must be U.S. citizens and successfully obtain government security clearance.

Responsibilities

The Telephonic Care Manager will provide comprehensive behavioral health case management over the phone to TRICARE beneficiaries, addressing their needs and conditions. Responsibilities include assessing, planning, coordinating, implementing, monitoring, and evaluating care to maximize self-care capacity and improve quality of life. The role involves acting as the primary point of contact for beneficiaries, coordinating with physicians and other healthcare providers to ensure integrated care plans, and documenting interventions. Additionally, the manager will provide telephonic guidance and support to beneficiaries and their families, identify gaps in care, utilize motivational interviewing techniques, address social determinants of health, and maintain privacy and confidentiality while adhering to ethical, legal, and regulatory standards.

Skills

Behavioral Health

Case Management

Care Coordination

Telephonic Communication

Clinical Assessment

Treatment Planning

TRICARE Program

Holistic Approach

Intervention Documentation

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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