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 (LTSS-ABD) who will lead a team of nurses and behavior health professionals responsible for care management of members, specifically the elderly or special needs populations such as the Aged, Blind and Disabled (ABD), those enrolled in Long-Term Services and Supports (LTSS) Waiver Services, in hospice and/or in nursing facilities. They will lead LTSS-ABD care management operations and staff to ensure timely and culturally competent delivery of care services and support compliance with contractual requirements and industry best practices.

The Manager, Care Management (LTSS-ABD) 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 care management personnel and care management functions, including assessment, care planning activities, and care coordination to ensure members/families maintain an optimal wellness state.
Develops care management policies and procedures to ensure compliance with state and federal requirements and incorporate industry best practices.
Conducts briefings, and area meetings, maintains frequent contact with other managers across the department.
Collaborates with internal and external providers or departments to meet the member's needs.
Oversees staff training, evaluation, and performance monitoring.
Supports the Director/Leadership in meeting the goals of department/market.
Monitors and maintain staffing levels to meet care and service quality objectives.
Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area and requires cross departmental collaboration.

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) license in the Commonwealth of Virginia.
Three (3) or more years of professional experience working with complex populations or in manage care settings.
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.
Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport.
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

Three (3) or more years of professional experience in Case Management, in Medicaid and/or Medicare, specifically in the delivery of care for elderly or special needs populations (such as the Aged, Blind and Disabled) those enrolled in LTSS Waiver Services, in hospice and/or in nursing facilities.
Previous experience in a field based or a homecarebased role.
Master's degree in human services, social sciences, or health related field.
Previous experience in utilization management, discharge planning and/or home health or rehabilitation.
Experience with health promotion, coaching and wellness.
Care Management certification (CCM).

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 emp