Manager, Care Management Behavioral Health

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.

The Manager, Care Management Behavioral Health (BH) leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management Behavioral Health 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. Additional Information: This is a remote position in Virginia. May need to go into Humana office located in Glen Allen, VA.

Oversees the assessment and evaluation of members' behavioral health needs and requirements to achieve and/or maintain an optimal wellness state. Manages the BH care management and care coordination team, as well as peer support liaisons, providing support to low, moderate, and high risks members, including those experiencing serious mental illness and serious emotional disturbances, guiding and facilitating connection to resources appropriate for the care and well-being of members. Provides leadership in the design and implementation of policies, processes, and procedures to ensure compliance with regulatory requirements by the Virginia Department of Medical Assistance Services (DMAS), the Center for Medicare and Medicaid Services (CMS), and the National Committee on Quality Assurance (NCQA). Collects and analyzes performance reports on care management and care coordination functions to monitor adherence with benchmarks, identify opportunities for process improvement, and develop recommendations to leadership. Collaborates with internal departments, providers, and community partners to support delivery of high-quality behavioral health care management and care coordination, including implementing innovative strategies to address unaddressed mental health and behavioral needs and create tools for recovery and resiliency. Influences and assists corporate leadership in strategic planning to improve effectiveness of care and the behavioral health services for maternal, adult, adolescent populations, and justice-involved members. Ability to work independently under general instructions and with a team. Collaborates with utilization management to coordinate seamless transitions for Members across crisis service continuum and those receiving DMAS mental health services. Provides ongoing coaching and feedback to enhance contribution, competency, and performance.