Care Manager, Telephonic Behavioral Health

Job Description

Become a part of our caring community

The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Care Manager, Telephonic Behavioral Health 2 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 patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Follows established guidelines/procedures.

- Humana is seeking a Care Manager, Telephonic Behavioral Health 2 to telephonically assess, evaluate, and support members who are challenged by both mental illness and complex medical situations. Our goal is to provide support for both mind and body to allow each member to achieve and/or maintain their optimal health.

- Apply your clinical knowledge to educate and empower your members, to take charge of their own healthcare decisions. Provide guidance and clinical expertise on how to navigate through the health care setting. Provide ongoing consultation with members via telephone to ensure that they are receiving the best quality of care possible. You will guide members and their families toward and facilitate interaction with resources appropriate for their care and wellbeing. You will work in collaboration with a multi-disciplinary team, employing a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Coordinate community care and services as deemed appropriate. Comply with performance and reporting standards as defined by Humana.

- Other responsibilities include:

- Proactive telephonic outreach to eligible Humana members and engage participation in appropriate care management programs

- Complete physical, psychological, emotional and environmental assessments, to provide appropriate, interventions to ensure provision of optimal care

- Based on identified needs, recommend and coordinate interventions that may include information, education, resources and referrals

- Coordinate community care and services as deemed appropriate

- Work with other members of the Interdisciplinary team - to include; LAL, IHWA, Social Services, Pharmacists, Psychiatrists, Utilization Management teams, Community Health Educators, EAP and others if appropriate

- Comply with performance and reporting standards as defined by Humana Corporation

- Use Motivational Interviewing and Solution-Oriented approaches in communication with members

- The working hours for this position are between 8:00am-7:00pm central standard time; but core hours are 8:00am-5:00pm central standard time.

Use your skills to make an impact

Required Qualifications

- Bachelor's degree

- 3+ years of experience working as a Licensed Clinical Social Worker or Licensed clinical Professional Counselor

- Licensure in field of study within the state of Illinois with no disciplinary action or can obtain IL licensure.

- 1 year of managed care experience

- Must be passionate about contributing to an organization focused on improving consumer experiences
Preferred Qualifications

- Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university

- Bilingual in English/Spanish, English/Polish, or English/Creole. Can speak, read, and write in both languages without limitations or assistance. See Additional Information on testing.

- Certified Case Manager (CCM)

- Experience with case management, discharge planning and patient education for adult acute care

- Managed care experience

- Prior experience with Medicare & Medicaid recipients

- Previous experience with electronic case note documentation and experienced with documenting in multiple computer applications/systems

- Experience with health promotion, coaching and wellness

- Knowledge of community health and social service agencies and additional community resources

Additional Information
Language Proficiency Testing
Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
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 individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$59,300 - $80,900 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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