The Manager, Care Management Behavioral Health leads teams of nurses and behavioral health professionals responsible for care management. The Manager, Behavioral Health Care Management, works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals.
Position Responsibilities:- Oversees the assessment and evaluation of members' behavioral health 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.
- Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
- Works cross departmentally and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
- Identifies and resolves barriers that hinder effective care.
- Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
- Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Use your skills to make an impact Required Qualifications:- Unrestricted Registered Nurse (RN) license in the state of South Carolina
- Bachelor's degree in Nursing (BSN)or a Licensed Master Level Clinician in the field of psychology or social work (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT)
- 5+ years of Behavioral Health professional experience
- 2+ years of management experience
- 2+ years Care Coordination/Case Management experience
- Proficiency in analyzing and interpreting data trends
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
- Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits
- Experience with NCQA to include leading re-accreditation activities
- Experience with NCQA, state audit, and external quality review (EQR)
Preferred Qualifications: - Previous experience working in a managed care field
- 5+ years of management/supervisor level experience
- 3+ years of clinical acute care experience in a behavioral health setting
- Certified Case Manager (CCM)
- Utilization management experience
Additional InformationWorkstyle: This is a remote position
Location: South Carolina
Schedule: Monday - Friday from 8-5pm
Travel: Occasional travel as business needs
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 Hours40
Pay RangeThe 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.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of BenefitsHumana, 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.
