HUMCS- Social Services Care Manager, Behavioral Health

Humana

2d•Remote

About The Position

Become a part of our caring community and help us put health first The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by guiding members and caregivers towards appropriate resources. Facilitate interactions with those resources by directly connecting the member and caregivers to close gaps in care within the community. The Care Manager, Telephonic Behavioral Health 2 is a Licensed, Masters level, Social Worker who functions as a Support Social Services associate (Support SS) in our Special Needs Plan (SNP) program and serves as part of an interdisciplinary care team member working with other disciplines, such as nurse care managers, dieticians, behavioral health, and pharmacists to help promote and support member health and well-being. This role requires the use of structured assessments along with critical thinking skills to determine appropriate interventions such as care coordination, health education, connection to community resources, full utilization of benefits and advocacy. This role requires effective and professional communication with providers, community resources, and other members of the interdisciplinary team to address member needs. The Support SSs daily job duties include making outbound call attempts to members with social determinants of health (SDOH) needs to assess and assist with coordinating care with available plan benefits and/or appropriate community resources in a telephonic, call center, work from home environment. This role does not carry a caseload but may require additional member follow-up to ensure that all needs have been assessed and addressed. The Support SS may also receive inbound calls from members needing additional assistance. This role is also responsible for assessing the member to determine if a referral to any other discipline is needed depending on member’s individualized needs. Creating and updating member care plans may be required. Documentation in the member’s record is required to ensure CMS compliance, and accurately reflect work with members, providers, and other members of the interdisciplinary care team. Use your skills to make an impact

Requirements

Master’s degree in social work from an accredited university
Current, unincumbered, social work license; LMSW, LCSW, LICSW
Must have passed ASWB Exam (Master, Advance Generalist, or Clinical level)
Minimum 3 years of experience working as a social worker in a medical healthcare setting
Proficient in Microsoft applications including Word, Outlook, Excel
Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously
Must be willing to obtain/maintain social work licensure in multiple states, based on business need
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

Experience working with geriatric, vulnerable, and/or low-income populations
Licensure in LA, MD, MI, MS, NV, NM, OK, VA
Bilingual English/Spanish
Bilingual English/Creole
Experience working with Medicare and Medicaid

Responsibilities

Assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness by guiding members and caregivers towards appropriate resources.
Facilitate interactions with those resources by directly connecting the member and caregivers to close gaps in care within the community.
Function as a Support Social Services associate (Support SS) in our Special Needs Plan (SNP) program and serves as part of an interdisciplinary care team member working with other disciplines, such as nurse care managers, dieticians, behavioral health, and pharmacists to help promote and support member health and well-being.
Use structured assessments along with critical thinking skills to determine appropriate interventions such as care coordination, health education, connection to community resources, full utilization of benefits and advocacy.
Communicate effectively and professionally with providers, community resources, and other members of the interdisciplinary team to address member needs.
Make outbound call attempts to members with social determinants of health (SDOH) needs to assess and assist with coordinating care with available plan benefits and/or appropriate community resources in a telephonic, call center, work from home environment.
Assess the member to determine if a referral to any other discipline is needed depending on member’s individualized needs.
Create and update member care plans may be required.
Documentation in the member’s record is required to ensure CMS compliance, and accurately reflect work with members, providers, and other members of the interdisciplinary care team.

Benefits

Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Parental and caregiver leave
Employee charity matching program
Network Resource Groups (NRGs)
Career development opportunities
Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.