Manager, Care Management - Washington, United States - Humana

Humana

Verified Company

Washington, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Become a part of our caring community and help us put health first:

Humana Healthy Horizons in Virginia is seeking a Manager, Care Management (Physical Health) who will lead teams of nurses and behavior 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.

Oversees the assessment and evaluation of members' physical health needs and requirements to achieve and/or maintain an 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 and requires cross departmental collaboration.
Conducts briefings, and area meetings, maintains frequent contact with other managers across the department.
Reviews processes to support contractual guidelines and adjusts accordingly.
Collects and analyzes performance reports on care management functions to monitor adherence with benchmarks, identify opportunities for process improvement, and develop recommendations to leadership.
Ability to work independently under general instructions and with a team.
Utilizes a holistic, Membercentric approach to engage and motivate Members and their families through recovery and health and wellness programs.
Provides ongoing coaching and feedback to enhance contribution, competency, and performance.
Maintains knowledge of Medicaid and its covered benefits and services for our membership.

Use your skills to make an impact
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Required Qualifications
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Must reside in the commonwealth of Virginia or within a 40-mile radius from Virginia in a bordering state/district _(Washington DC, MD, WV, KY, TN & NC)_

:

An active, unrestricted Registered Nurse (RN) license or Licensed Mental Health Professional (LMHP) in the Commonwealth of Virginia.
Three (3) or more years of professional experience in Care Management, specifically in the delivery of care for the physical health needs of members in Medicaid and/or Medicare.
Experience with working with adult and/or Pediatric populations with mild to complex needs.
Two (2) or more years of management or supervisory experience.
Proficiency in analyzing and interpreting data trends.
Progressive business consulting and/or operational leadership experience.
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.
Must be able to travel throughout the Commonwealth of Virginia.
This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

Preferred Qualifications

Advanced degree in nursing or related field.
Three (3) or more years of previous experience working in a managed care field.
Previous experience in a field based or a homecarebased role.
Experience with transitions of care model and chronic illnesses.

Additional Information
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Workstyle:

This is a remote position that will require you to travel.
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Travel:

Up to 25% of the time to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as field interactions with providers, members, and their families.

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Typical Workdays and Hours:

Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST).
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Direct Reports:

Up to 15.

Work at Home Internet Statement
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 biweekly 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.

HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills an