Field Care Manager Behavioral Health (Macomb & Wayne)

Humana•Chittenden, VT

10d•$65,000 - $88,600•Hybrid

About The Position

The Field Care Manager Behavioral Health develops behavioral health strategies and supports best practices and processes that improve member outcomes. The role focuses on mental health and substance use services, assessing and evaluating member needs, and supporting optimal wellness. As a member of the Interdisciplinary Care Team, the position coordinates strategies and techniques to address members’ psychosocial health needs and help them access appropriate behavioral health care. The role serves as a primary connection between members, Prepaid Inpatient Health Plans (PIHPs), clinicians, Humana Behavioral Health, and internal care teams. It reviews referrals, connects members to appropriate providers, supports transitions and follow-up, and helps prevent gaps in care. The position also provides behavioral health expertise to care management teams and supports integrated, member-centered care. This is a hybrid role based in Michigan, with 80% remote work and 20% field work and travel to Wayne and Macomb counties. The schedule is 40 hours per week. Initial training is four weeks, Monday through Friday, 8:30 AM to 5:00 PM EST; afterward, the 8-hour shift is scheduled between 9:00 AM and 5:30 PM EST. Occasional travel to Humana offices for training or meetings may also be required. The role is patient-facing and subject to TB screening. Home or hybrid employees must have an appropriate dedicated workspace and internet service meeting the stated speed requirements.

Requirements

Must reside in Michigan and be able to travel to Wayne and Macomb counties.
Active Michigan social work licensure in good standing: LPC, LLBSW, LBSW, LLMSW, LMSW, or LCSW. Limited license holders must demonstrate intent and active progress toward full licensure.
At least 2 years of experience in an integrated care setting supporting members with behavioral health and/or substance use needs, such as crisis services, emergency room settings, community mental health centers, behavioral health inpatient settings, or Assertive Community Treatment programs.
Experience in a managed care environment.
Experience supporting behavioral change, health promotion, coaching, and/or wellness initiatives.
Experience in strategy development, care management liaison roles, and interdisciplinary collaboration.
Proficiency with Word, Excel, PowerPoint, and shared systems, including the ability to troubleshoot and resolve general technical issues.
Knowledge of regulatory standards and best practices related to behavioral health.
Valid state driver's license and personal vehicle liability insurance meeting the stated requirements.
Ability to meet the work-at-home requirements, including minimum internet speeds of 25 Mbps download and 10 Mbps upload and a dedicated workspace that protects member PHI/HIPAA information.

Nice To Haves

Experience supporting patients telephonically.
Experience working in Community Mental Health, on a crisis response team, on an Assertive Community Treatment team, and/or in substance use disorder treatment.
Experience working with both children and adults.

Responsibilities

Serve as the primary point of contact between PIHPs and members receiving behavioral health services, supporting timely access to care and continuity of services.
Receive and review referrals from Humana Behavioral Health for members with newly identified behavioral health needs.
Connect members with PIHPs or other appropriate providers to support smooth and timely transitions of care.
Conduct member outreach and education about behavioral health services.
Follow up with members after referral outcomes, including denied services or unsuccessful contact attempts, to address needs and prevent gaps in care.
Assess risk and determine appropriate care within individual member communities.
Collaborate with providers to support member care and service coordination.
Partner with Special Needs Plan Care Coordinators and other care team members to address case management concerns and coordinate member care.
Serve as a behavioral health subject matter resource for care management teams and internal stakeholders.
Coordinate with Humana Behavioral Health, PIHPs, and internal teams on integrated care and follow-up activities.
Analyze complex behavioral health cases and use sound judgment to identify appropriate care strategies and resource needs.
Monitor and manage follow-up activities related to referral dispositions, including unable-to-contact and denied-service outcomes.
Collaborate with interdisciplinary teams to identify and address behavioral health and broader care management needs.
Support integrated, member-centered care that promotes improved health and well-being.
Exercise independent decision-making and perform responsibilities effectively with minimal supervision.
Participate in community engagement and provider relations activities, including meetings and events with community organizations, provider groups, and advisory councils.