Humana
This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range
$86,300.00/yr - $118,700.00/yr Become a part of our caring community and help us put health first Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral 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. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. The Manager, Care Management supervises, directs and evaluates a diverse group of health care professionals to assure effectiveness of care coordination activities. Leads cross-functional collaboration through regular briefings and area meetings; maintains ongoing communication with departmental managers to ensure alignment and operational efficiency. Identify members for specific case management and / or disease management activities. Monitors case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions. Develop system-view recommendations, reports trends and implement appropriate actions to control trends. Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met. Develop reporting tools in collaboration with leadership to identify clinical performance. Interviews, hires, mentors, evaluates, coaches and manages performance for a diverse care coordination team. Onboards new associates including but not limited to all pre-employment human resource tasks, ordering software, hardware, supplies and support technologies. Monitors performance of staff including service performance and adherence to established utilization and care coordination benchmarks. Required Qualifications Must reside in the state of Illinois An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois. Five (5) or more years of professional experience working in the health care industry and/or in care management. Two (2) or more years of leadership experience. Comprehensive knowledge of all Microsoft Office applications, specifically Word, Excel, and PowerPoint. Ability to use a variety of electronic information applications/software programs including electronic medical records. Proficiency in analyzing and interpreting data trends. This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Ability to travel throughout the state of Illinois. This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Preferred Qualifications Advanced degree in nursing or business health field. Certified Case Manager (CCM). Previous experience working in a managed care field. Five (5) or more years of previous management/supervisor level experience to include hiring, training, mentoring and coaching associates. Prior experience with healthcare quality measures STARS, HEDIS, etc. and/or clinical program monitoring/evaluation. Knowledge of community health and social service agencies and additional community resources. Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. Additional Information Workstyle: This is a remote position that requires travel. Travel: 50 – 75% field-based interactions conducting care team oversight visits, meeting with members and/or their families, community partners and other care teams. Typical Workdays and Hours: Monday - Friday 8:00 AM - 5:00 PM CST. Direct Reports: Up to 15 associates. Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. WAH Internet Statement 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. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. $86,300 - $118,700 per year Description Of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.
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$86,300.00/yr - $118,700.00/yr Become a part of our caring community and help us put health first Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral 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. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. The Manager, Care Management supervises, directs and evaluates a diverse group of health care professionals to assure effectiveness of care coordination activities. Leads cross-functional collaboration through regular briefings and area meetings; maintains ongoing communication with departmental managers to ensure alignment and operational efficiency. Identify members for specific case management and / or disease management activities. Monitors case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions. Develop system-view recommendations, reports trends and implement appropriate actions to control trends. Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met. Develop reporting tools in collaboration with leadership to identify clinical performance. Interviews, hires, mentors, evaluates, coaches and manages performance for a diverse care coordination team. Onboards new associates including but not limited to all pre-employment human resource tasks, ordering software, hardware, supplies and support technologies. Monitors performance of staff including service performance and adherence to established utilization and care coordination benchmarks. Required Qualifications Must reside in the state of Illinois An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois. Five (5) or more years of professional experience working in the health care industry and/or in care management. Two (2) or more years of leadership experience. Comprehensive knowledge of all Microsoft Office applications, specifically Word, Excel, and PowerPoint. Ability to use a variety of electronic information applications/software programs including electronic medical records. Proficiency in analyzing and interpreting data trends. This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Ability to travel throughout the state of Illinois. This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Preferred Qualifications Advanced degree in nursing or business health field. Certified Case Manager (CCM). Previous experience working in a managed care field. Five (5) or more years of previous management/supervisor level experience to include hiring, training, mentoring and coaching associates. Prior experience with healthcare quality measures STARS, HEDIS, etc. and/or clinical program monitoring/evaluation. Knowledge of community health and social service agencies and additional community resources. Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. Additional Information Workstyle: This is a remote position that requires travel. Travel: 50 – 75% field-based interactions conducting care team oversight visits, meeting with members and/or their families, community partners and other care teams. Typical Workdays and Hours: Monday - Friday 8:00 AM - 5:00 PM CST. Direct Reports: Up to 15 associates. Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. WAH Internet Statement 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. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. $86,300 - $118,700 per year Description Of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.
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