The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, 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.
The Manager, Care Management oversees the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
The Manager of Care Management:
- Requires cross-departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
- Responsible for and oversees delivery of care to all members served by the location.
- Reviews available information related to the member's case, including disciplines required, to determine assessment needs.
- Monitor performance of staff including service performance and adherence to established care coordination benchmarks.
- Identify members for specific case management and / or disease management activities.
- Develop audit plans and tools for teams to ensure compliance with state contract on performance metrics and to ensure member needs are met.
- Develops reporting tools in collaboration with leadership to identify clinical performance.
- Responsible for interviewing, hiring, coaching, evaluating, and mentoring a diverse care coordination work force.
- Onboard new staff including but not limited all pre-employment human resource tasks, ordering of software, hardware, supplies and support technologies.
- Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions.
Use your skills to make an impact Required Qualifications - Must reside in Michigan and be able to travel to Wayne County or Macomb County.
- Active Registered Nurse (RN) license or Social Work (SW) license in the state of Michigan
- 3+ years of professional experience as a licensed RN or Social Worker to include experience in case and/or disease management
- 1+ year of leadership and people management experience in a home care, hospice, or similar field-based healthcare setting.
- Demonstrated experience coaching, supporting, and developing clinicians in a fast-paced healthcare environment.
- Proficiency in analyzing and interpreting data trends.
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
Preferred Qualifications - Minimum education of an Associate's Degree
- Certified Case Manager (CCM)
- 3+ years of previous management/supervisor level experience
- Experience with Medicaid Long Term Care
- Fully Bilingual in English and Spanish or Arabic
Work Details/Additional Information- Work Location: Michigan (Malcom and Wayne counties)
- Work Style: This is a remote- field position where employees perform their core duties from a home office with travel as needed to support Field Clinicians
- Schedule/Time Zone: Core hours are Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST) as well as occasional weekend hours, as needed, to support the business
- Travel Requirements: Up to 50% travel within Wayne and Macomb Counties for field-based interactions.
- Number of Direct Reports: 13
Language Assessment Statement: 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.
TB Statement: This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Driving Statement: This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
- Eligible mileage includes:
- Travel from your home to your first work location of the day.
- Travel between client or assignment locations during the workday.
- Travel from your final work location back to your home.
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.
$86,300 - $118,700 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.
