Become a part of our caring community and help us put health first
Why Humana?At Humana, caring is everything. You look after our members and patients. We look after you. If caring means something to you too, we’ve got a spot for you. We design competitive and flexible benefits packages to provide our employees a sense of financial security now and in the future.
Fostering a culture of inclusion is part of the fabric of who we are. We must have a workplace that reflects the people we serve and thrives in part because every person can bring their whole self to work to do their best work. Our vibrant, diverse culture and environment of inclusion is one of our greatest strengths.
About Humana Healthy Horizons
Humana Healthy Horizons is more than a health plan. We’re human care. Humana Healthy Horizons focuses on helping people achieve their best health. Our dedicated strategies across various markets and states are enabled by partnerships with state and local governments, community-based organizations, and national partners committed to removing barriers to helping people achieve their best health.
The Manager, Care Management Behavioral Health leads teams of nurses and behavioral health professionals responsible for care management. The Manager, Behavioral Health 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.
Position 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.
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 passionate about contributing to an organization focused on continuously improving consumer experiences
Use your skills to make an impact
Required Qualifications:
Unrestricted Current Licensed Registered Nurse (RN) in the state of South Carolina
Bachelor’s degree 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
Experience with NCQA to include leading re-accreditation activities
Experience with NCQA, state audit, and external quality review (EQR)
Preferred Qualifications:
Previous experience working in a managed care field
5 or more years of previous management/supervisor level experience
3+ years of clinical acute care experience in a behavioral health setting
Certified Case Manager (CCM)
Utilization management experience
Additional Information
Workstyle: This is a remote position
Location: South Carolina
Schedule: 8-5
Travel: Occasional travel as business needs
Work at Home Criteria
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; 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 Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
SSN Alert Statement
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Humana offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
Medical Benefits
Dental Benefits
Vision Benefits
Health and Childcare Savings Accounts
Flex Spending Accounts
Life Insurance
401K / Roth
Education Reimbursement
23 days Paid Time off accrual, 7 paid holidays, two personal holidays, one day of volunteer time off, parental leave, caregiving leave, and weekly well-being time , and more!
Scheduled Weekly Hours
40Pay 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. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$76,800 - $105,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, 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.About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.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 because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
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