Humana · 4 days ago

Care Manager - Telephonic Physical Health

Remote Oklahoma

Full-time

Remote

Entry, Mid Level

$70K/yr - $96K/yr

2+ years exp

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Responsibilities

Performs telephonic and face to face assessments and evaluations of the member’s needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member.

Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations.

Creates member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

Employs a variety of strategies, approaches, and techniques to manage an Enrollee’s behavioral, physical, environmental, and psycho-social health needs.

Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations.

Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.

Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed.

Follows established guidelines/procedures.

Collaborates with providers and community services to promote quality and cost-effective outcomes.

Periodic travel to Humana Oklahoma City office for meetings and training.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Registered Nurse (RN)Licensed Clinical Social Worker (LCSW)Licensed Professional Counselor (LPC)Licensed MarriageFamily Therapist (LMFT)Licensed Professional Clinical Counselor (LPCC)Licensed Professional Art Therapist (LPAT)Clinical experienceIn-home case managementCommunity health knowledgeMicrosoft OfficeMedicaid experienceMedicare experienceBilingual SpanishBilingual EnglishCase Management Certification (CCM)

Required

Must Reside in Oklahoma

Candidates must have one of the following: Active Registered Nurse (RN) license (without restrictions), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Art Therapist (LPAT)

Minimum 1-year clinical experience

2 or more years of experience of in-home case or care management

Exceptional communication and interpersonal skills with the ability to quickly build rapport.

Knowledge of community health and social service agencies and additional community resources.

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.

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.

This role is considered member facing and is part of Humana Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.