Care Manager Telephonic Behavioral Health

Humana•Carolina, SC

5d•Remote

About The Position

The Care Manager, Telephonic Behavioral Health assesses and evaluates members’ needs in a telephonic environment, guiding members and families toward resources that support members’ care and wellbeing. The role uses varied strategies to manage members’ physical, environmental, and psychosocial health issues, resolve barriers to care, and monitor progress toward desired outcomes through assessments and evaluations. The Care Manager may create member care plans and independently determine appropriate courses of action within organizational and departmental strategies. The position supports the Transition of Care (TOC) program, helping maintain continuity of care as members move between settings, such as from hospital discharge to home or outpatient care. Responsibilities include follow-up visits for HEDIS completion after facility discharge and, when member needs and program requirements call for it, field visits. The role is remote, requires residence in South Carolina, and involves occasional travel of approximately 5–10% for collaboration, face-to-face meetings, and engagement with staff, providers, members, and families. The schedule is Monday through Friday, 8:00 AM–5:00 PM Eastern Time, for 40 hours per week.

Requirements

Must reside in South Carolina.
Must hold an active South Carolina license as a Licensed Professional Counselor (LPC), Licensed Independent Social Worker – Clinical Practice (LISW-CP), or Licensed Independent Social Worker – Advanced Practice (LISW-AP).
At least 1 year of related work experience.
For home work, provide internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable, or DSL is suggested.
Work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information.

Nice To Haves

Bachelor’s or master’s degree in a behavioral-health field, such as social work, psychology, or a related health discipline, from an accredited university.
1 year of managed care experience.
Transition of Care experience in Physical Health and/or Behavioral Health.
1 year of inpatient behavioral health or case management experience in a hospital setting.
CCM certification.
Experience working with the Medicaid population.
Knowledge of community health and social service agencies and additional community resources.

Responsibilities

Assess and evaluate members’ needs in a telephonic environment.
Guide members and families toward appropriate care and wellbeing resources and facilitate interaction with those resources.
Use strategies and techniques to manage members’ physical, environmental, and psychosocial health issues.
Resolve barriers that hinder care.
Monitor patient care through assessments and evaluations to ensure progress toward desired outcomes.
Create member care plans as needed.
Support the Transition of Care program to help ensure continuity of care as members move between care settings.
Assist with HEDIS completion follow-up visits after facility discharge.
Conduct field visits when required by member needs and program requirements.
Travel occasionally to collaborate and meet face-to-face with staff, providers, members, and families.