Field Care Manager Behavioral Health (Macomb & Wayne)

Humana • Chittenden, VT

1d • $65,000 - $88,600 • Hybrid

About The Position

The Behavioral Health CM Liaison develops behavioral health strategies across the enterprise, business, or segment to support best practices and processes that improve member outcomes. This role works on problems of diverse scope and complexity, ranging from moderate to substantial. The Behavioral Health CM Liaison develops behavioral health strategies that include mental health and substance use services. Responsibilities include assessing and evaluating member needs to help achieve and maintain optimal wellness. As a member of the Interdisciplinary Care Team, the Behavioral Health CM Liaison coordinates and applies a variety of strategies, approaches, and techniques to support members' psychosocial health needs. This position supports Humana members' access to behavioral health services, with a focus on addressing the growing need for behavioral health care.

Requirements

• Must reside in the State of Michigan with the ability to travel to Wayne and Macomb counties (15–20%).
• Active Michigan social work licensure in good standing, including one of the following: LLBSW, LBSW, LLMSW, LMSW, or LCSW. Limited license holders must demonstrate intent and active progress toward full licensure.
• 2+ years of experience in an integrated care setting supporting members with behavioral health and/or substance use needs, such as crisis services (including emergency room settings), community mental health centers, behavioral health inpatient settings, or Assertive Community Treatment (ACT) 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 software applications, including Word, Excel, PowerPoint, and shared systems; ability to troubleshoot and resolve general technical issues.
• Knowledge of regulatory standards and best practices related to behavioral health.

Nice To Haves

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

Responsibilities

• Conducting member outreach and education related to behavioral health services.
• Assessing risk and determining appropriate care within individual member communities.
• Collaborating with providers to support member care and service coordination.
• Bridging gaps between the Health Plan, Prepaid Inpatient Health Plans (PIHPs), and clinicians across other Humana departments.
• Supporting access to behavioral health services and resources for members.
• Serve as the primary point of contact between Prepaid Inpatient Health Plans (PIHPs) and members receiving behavioral health services, helping ensure 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 outreach to members following referral outcomes, including situations where services were denied or members could not be reached, to help address behavioral health needs and prevent gaps in care.
• Partner with Special Needs Plan Care Coordinators and other care team members to address case management concerns and support coordinated 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 to support 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.
• Travel may include participation in community engagement and provider relations activities, providing a behavioral health perspective during meetings and events with community organizations, provider groups, and advisory councils.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed