Associate Director, Care Management
About The Position
Humana Gold Plus Integrated is seeking Associate Directors of Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding of how organizational capabilities interrelate across department(s). The Associate Director, Care Management, makes decisions related to resolving complex technical and operational problems within department(s). You will oversee the assessment and evaluation of members' needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. You will guide the development, implementation, and evaluation of care management programs to align organizational objectives and regulatory requirements. You will lead multiple managers or highly specialized professional associates. You will monitor data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities. You will facilitate effective communication and collaboration with internal and external stakeholders, including providers, payers, and regulatory agencies. You will lead the preparation and presentation of program reports, utilizing data analytics to monitor performance, identify trends, and recommend improvements. You will champion initiatives for process improvement and innovation to advance care management practices and outcomes.
Requirements
- Must reside in the state of Illinois, Indiana or Wisconsin.
- An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois.
- Six (6) or more years of professional experience working in the health care or managed care industry.
- Three (3) or more years' experience working for a managed care health plan.
- Minimum of two (2) years of experience in a leadership role managing other leaders or supervisors.
- Three (3) or more years of experience leading care coordination teams to drive measurable outcomes across diverse member populations.
- Proficiency in analyzing and interpreting data trends.
- Progressive business consulting and/or operational leadership experience.
- Must be able to travel in the state of Illinois to provider offices, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare & Medicaid Services (CMS) and Humana's Illinois locations.
Nice To Haves
- Advanced degree in nursing, Social Work or business-related field
- Experience with MLTSS and HealthChoice Populations.
- Previous experience working in a managed care field
- Five (5) or more years of previous management/supervisory level experience.
Responsibilities
- Oversee the assessment and evaluation of members' needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
- Guide the development, implementation, and evaluation of care management programs to align organizational objectives and regulatory requirements.
- Lead multiple managers or highly specialized professional associates.
- Monitor data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities.
- Facilitate effective communication and collaboration with internal and external stakeholders, including providers, payers, and regulatory agencies.
- Lead the preparation and presentation of program reports, utilizing data analytics to monitor performance, identify trends, and recommend improvements.
- Champion initiatives for process improvement and innovation to advance care management practices and outcomes.
Benefits
- medical
- dental
- 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
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Associate degree
