Manager, Care Management

Humana • North Chicago, IL

21h • $86,300 - $118,700 • Remote

About The Position

The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. The Manager, Care Management supervises, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordinators activities. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross-departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department. Develop system-view recommendations. Report trends. Implement appropriate actions to control trends. Develop audit plans and tools for teams to ensure compliance with state contract on performance metrics and to ensure member needs are met. Develop reporting tools in collaboration with leadership to identify clinical performance. Interviewing, hiring, disciplining, evaluating and mentoring a diverse care coordination work force. Onboard new staff including but not limited all pre-employment human resource tasks, ordering of software, hardware, supplies and support technologies. Monitor performance of staff including service performance and adherence to establish utilization and care coordination benchmarks. Identify members for specific case management and / or disease management activities. Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions. Requires travel, 50 – 75% of the time.

Requirements

• Associate's Degree
• Active Registered Nurse (RN) license or Social Work (SW) license
• 5 or more years of professional experience
• 2 or more years of management experience
• Proficiency in analyzing and interpreting data trends.
• Progressive business consulting and/or operational leadership experience

Nice To Haves

• Bachelor's degree or advanced degree in nursing or business health field
• Previous experience working in a managed care field
• 5 or more years of previous management/supervisor level experience

Responsibilities

• Supervises, directs and evaluates a diverse group of health care professionals to assure effectiveness of care coordinators activities.
• Develop system-view recommendations.
• Report trends and implement appropriate actions to control trends.
• Develop audit plans and tools for teams to ensure compliance with state contract on performance metrics and to ensure member needs are met.
• Develop reporting tools in collaboration with leadership to identify clinical performance.
• Interviewing, hiring, disciplining, evaluating and mentoring a diverse care coordination work force.
• Onboard new staff including but not limited all pre-employment human resource tasks, ordering of software, hardware, supplies and support technologies.
• Monitor performance of staff including service performance and adherence to establish utilization and care coordination benchmarks.
• Identify members for specific case management and / or disease management activities.
• Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions.

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
• Education Level: Associate degree