Manager, Care Management Behavioral Health

Humana • Carolina, SC

13d • Remote

About The Position

Humana Healthy Horizons is seeking a Manager, Care Management Behavioral Health to lead teams of nurses and behavioral health professionals responsible for care management. This role involves overseeing the assessment and evaluation of members' behavioral health needs, guiding them towards appropriate resources, and making decisions related to project operations. The position requires working cross-departmentally, contributing to program deployment, and identifying/resolving care barriers. The ideal candidate will understand organizational strategy, make independent decisions regarding work methods, and be comfortable leading a hybrid/remote team. A passion for improving consumer experiences is essential.

Requirements

• Unrestricted Registered Nurse (RN) license in the state of South Carolina
• Bachelor’s degree in Nursing (BSN) or a Licensed Master Level Clinician in the field of psychology or social work (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT)
• 5+ years of Behavioral Health professional experience
• 2+ years of management experience
• 2+ years Care Coordination/Case Management experience
• Proficiency in analyzing and interpreting data trends
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
• Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits

Nice To Haves

• Previous experience working in a managed care field
• 5+ years of management/supervisor level experience
• 3+ years of clinical acute care experience in a behavioral health setting
• Certified Case Manager (CCM)
• Utilization management experience

Responsibilities

• Oversees the assessment and evaluation of members' behavioral health needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
• Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
• Works cross departmentally and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
• Contributes to decisions about process and methodology for Intensive Case Management and Behavioral Health and responsible for deployment of program.
• Identifies and resolves barriers that hinder effective care.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Must be comfortable, experienced leading a hybrid/remote team.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

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: Manager