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Humana Gold Plus Integrated is seeking a Manager, Care Management, who 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, supervises, directs, and evaluates a diverse group of health care professionals to assure effectiveness of care coordinators activities. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross-departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department. Key responsibilities include:
Use your skills to make an impact
Required Qualifications
Work at Home Requirements
Preferred Qualifications
Additional Information
Must reside in the Greater Chicago Area.
Direct Reports: Up to 15 Associates.
Hours: Typically, Monday-Friday 8:00 AM - 5:00 PM (flexible with schedule if needed) with rotating on-call/oversight during weekends and holidays.
Work Location and Travel: Considered primarily remote/work at home (WAH) position but will require travel 50% - 75%. Must be able to travel occasionally to Humana's office location in Schaumburg, IL.
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
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.
$84,600 - $116,300 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.
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 because he or she is a protected veteran. It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
Humana Gold Plus Integrated is seeking a Manager, Care Management, who 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, supervises, directs, and evaluates a diverse group of health care professionals to assure effectiveness of care coordinators activities. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross-departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department. Key responsibilities include:
- Develop system-view recommendations.
- Report trends.
- Implement appropriate actions to control trends.
- Develop audit plans and tools for teams to ensure compliance with state contract on performance metrics and to ensure member needs are met.
- Develop reporting tools in collaboration with leadership to identify clinical performance.
- Interviewing, hiring, disciplining, 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 performance of staff including service performance and adherence to establish utilization and care coordination benchmarks.
- Identify members for specific case management and / or disease management activities.
- Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions.
- Requires travel, 50 - 75% of the time.
Use your skills to make an impact
Required Qualifications
- Must reside in the Greater Chicago Area or surrounding counties.
- Bachelor's Degree with an active Registered Nurse (RN) license, Licensed Clinical Professional Counselor, or Master Social Worker with license in state of Illinois without restrictions.
- 5+ years of professional experience.
- 2+ years of leadership experience.
- Prior experience in health care industry/setting and/or case management.
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint
- Ability to use a variety of electronic information applications/software programs including electronic medical records.
- Proficiency in analyzing and interpreting data trends.
- Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
- This role is a part of Humana's Driver Safety program and therefore requires and individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,00 limits.
- This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Work at Home Requirements
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Preferred Qualifications
- Advanced degree in nursing or business health field.
- Certified Case Manager (CCM).
- Previous experience working in a managed care field.
- 5 or more years of previous management/supervisor level experience.
- Prior experience with healthcare quality measures STARS, HEDIS, etc. and/or clinical program monitoring/evaluation.
- Knowledge of community health and social service agencies and additional community resources.
- Proven ability of critical thinking, organization, written and verbal communication, problem-solving, and analytical skills.
Additional Information
Must reside in the Greater Chicago Area.
Direct Reports: Up to 15 Associates.
Hours: Typically, Monday-Friday 8:00 AM - 5:00 PM (flexible with schedule if needed) with rotating on-call/oversight during weekends and holidays.
Work Location and Travel: Considered primarily remote/work at home (WAH) position but will require travel 50% - 75%. Must be able to travel occasionally to Humana's office location in Schaumburg, IL.
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
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.
$84,600 - $116,300 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.
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 because he or she is a protected veteran. It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
