Job description
Become a part of our caring community
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.
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.
• Contributes to decisions about process and methodology for Intensive Case Management and Behavioral Health and responsible for deployment of program.
• 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 comfortable, experienced leading a hybrid/remote team.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Use your skills to make an impact
Requirements
- • Unrestricted Registered Nurse (RN) license in the state of South Carolina
• Bachelor’s degree in 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
• Previous experience working in a managed care field
• 5+ years of 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: Monday - Friday from 8-5pm
Travel: Occasional travel as business needs
Work at Home Requirements: 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
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. 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.
$78,400 - $107,800 per year
This 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Humana
Humana's Primary Care Organization operates 340+ senior-focused primary care centers across 15 states under the CenterWell and Conviva brands, providing value-based care to adult and geriatric patients. They hire Nurse Practitioners for part-time roles in collaborative, team-based primary care settings with lower patient volumes, and they hire bilingual Registered Nurses for remote telephonic care management positions supporting members with chronic and complex health conditions, requiring assessment, care planning, and coordination with interdisciplinary teams.
