Humana
Base pay range: $104,000.00/yr - $143,000.00/yr. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Associate Director, Care Management – Humana Gold Plus Integrated Become a part of our caring community and help us put health first.
Responsibilities
Oversee the assessment and evaluation of members’ needs and requirements to achieve and/or maintain an optimal wellness state by guiding families toward and facilitating interaction with resources appropriate for the care and wellbeing of members.
Guide the development, implementation, and evaluation of care management programs to align organizational objectives and regulatory requirements.
Lead multiple managers or highly specialized professional associates.
Monitor data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities.
Facilitate effective communication and collaboration with internal and external stakeholders, including providers, payers, and regulatory agencies.
Lead the preparation and presentation of program reports, utilizing data analytics to monitor performance, identify trends, and recommend improvements.
Champion initiatives for process improvement and innovation to advance care management practices and outcomes.
Required Qualifications
Must reside in the state of Illinois, Indiana or Wisconsin.
An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois.
Six (6) or more years of professional experience working in the health care or managed care industry.
Three (3) or more years’ experience working for a managed care health plan.
Minimum of two (2) years of experience in a leadership role managing other leaders or supervisors.
Three (3) or more years of experience leading care coordination teams to drive measurable outcomes across diverse member populations.
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
Proficiency in analyzing and interpreting data trends.
Progressive business consulting and/or operational leadership experience.
Must be able to travel within the state of Illinois to provider offices, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare & Medicaid Services (CMS) and Humana's Illinois locations.
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.
Preferred Qualifications
Residency in the state of Illinois.
Advanced degree in nursing, Social Work or business-related field.
Previous experience working in a managed care field.
Five (5) or more years of previous management/supervisory level experience.
Additional Information
Workstyle: This is a remote position.
Travel: Up to 25% to provider offices, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare & Medicaid Services (CMS) and Humana's Illinois locations for team engagement meetings.
Direct Reports: Up to 8.
Internet Requirement for Remote Employees
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 the 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 use an interview technology called HireVue to enhance our hiring and decision‑making ability.
Schedule & Compensation Weekly hours: 40. Pay range: $104,000 – $143,000 per year. This job is eligible for a bonus incentive plan.
Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole‑person well‑being, including medical, dental and vision benefits, a 401(k) retirement savings plan, paid time off, life insurance, and more.
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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
#J-18808-Ljbffr
Associate Director, Care Management – Humana Gold Plus Integrated Become a part of our caring community and help us put health first.
Responsibilities
Oversee the assessment and evaluation of members’ needs and requirements to achieve and/or maintain an optimal wellness state by guiding families toward and facilitating interaction with resources appropriate for the care and wellbeing of members.
Guide the development, implementation, and evaluation of care management programs to align organizational objectives and regulatory requirements.
Lead multiple managers or highly specialized professional associates.
Monitor data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities.
Facilitate effective communication and collaboration with internal and external stakeholders, including providers, payers, and regulatory agencies.
Lead the preparation and presentation of program reports, utilizing data analytics to monitor performance, identify trends, and recommend improvements.
Champion initiatives for process improvement and innovation to advance care management practices and outcomes.
Required Qualifications
Must reside in the state of Illinois, Indiana or Wisconsin.
An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois.
Six (6) or more years of professional experience working in the health care or managed care industry.
Three (3) or more years’ experience working for a managed care health plan.
Minimum of two (2) years of experience in a leadership role managing other leaders or supervisors.
Three (3) or more years of experience leading care coordination teams to drive measurable outcomes across diverse member populations.
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
Proficiency in analyzing and interpreting data trends.
Progressive business consulting and/or operational leadership experience.
Must be able to travel within the state of Illinois to provider offices, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare & Medicaid Services (CMS) and Humana's Illinois locations.
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.
Preferred Qualifications
Residency in the state of Illinois.
Advanced degree in nursing, Social Work or business-related field.
Previous experience working in a managed care field.
Five (5) or more years of previous management/supervisory level experience.
Additional Information
Workstyle: This is a remote position.
Travel: Up to 25% to provider offices, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare & Medicaid Services (CMS) and Humana's Illinois locations for team engagement meetings.
Direct Reports: Up to 8.
Internet Requirement for Remote Employees
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 the 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 use an interview technology called HireVue to enhance our hiring and decision‑making ability.
Schedule & Compensation Weekly hours: 40. Pay range: $104,000 – $143,000 per year. This job is eligible for a bonus incentive plan.
Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole‑person well‑being, including medical, dental and vision benefits, a 401(k) retirement savings plan, paid time off, life insurance, and more.
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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
#J-18808-Ljbffr