Care Manager - Behavioral Health

Humana • Work at Home - Oklahoma, OK

1d • $59,300 - $80,900 • Remote

About The Position

The individual in this role will work as an Oklahoma-based, primarily telephonic care manager, assessing and evaluating enrollees' needs and requirements to achieve or maintain optimal wellness by guiding enrollees/families towards and facilitating interaction with appropriate resources for their care and wellbeing. The individual in this role will work in collaboration with the interdisciplinary care management team. This team includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. The Care Manager, Telephonic Behavioral Health Nurse work assignments are varied but will focus on those enrollees with primarily behavioral health needs. The Care Manager, Behavioral Telephonic Nurse will utilize clinical expertise and experience to determine when face-to-face enrollee support is required. The Care Manager will engage the appropriate members of the care management team and/or coordinate in-person meetings between the care manager and the enrollee. This team-based approach is designed to ensure enrollees receive holistic person-centered care. Work assignments for this role are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Requirements

• Must Reside in Oklahoma
• Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker (LCSW, LPC, LMFT)
• Minimum 1-year Behavioral Health clinical experience
• 2 or more years of experience of in-home case or care management
• Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
• Knowledge of community health and social service agencies and additional community resources
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
• Periodic travel to Humana Oklahoma City office for meetings and training

Nice To Haves

• Case Management Certification (CCM)

Responsibilities

• Perform telephonic and face-to-face assessments and evaluations of the member's needs and requirements. These assessments aim to achieve and/or maintain an optimal wellness state. The goal is achieved by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member.
• Ensure member is progressing towards desired outcomes by monitoring care through assessments and/or evaluations.
• Create member care plans. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Employ a variety of strategies, approaches, and techniques to manage an Enrollee's behavioral, physical, environmental, and psycho-social health needs.
• Ensure Enrollees are progressing toward desired outcomes by monitoring their assessments and evaluations.
• Identify and resolve barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
• Follow established guidelines/procedures.
• Collaborate with providers and community services to promote quality and cost-effective outcomes.

Benefits

• medical
• dental
• vision
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree