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Humana

Sells Medicare health plans and runs senior clinics

Behavioral Health Liaison

Mental & Behavioral HealthPosted on Nov 9
Full-timeMichigan, USA

About the Job

Requirements

  • Must reside in Michigan and be able to travel to Wayne and Macomb counties.
  • Must hold an active Michigan social work license in good standing, including LPC, LPCC, BSW, MSW, LLBSW, LBSW, LLMSW, LMSW, or LCSW; limited-license holders must demonstrate intent and active progress toward full licensure.
  • Must have at least 2 years of experience in an integrated care setting supporting members with behavioral health and/or substance use needs, such as crisis services including emergency room settings, community mental health centers, behavioral health inpatient settings, or Assertive Community Treatment programs.
  • Must have experience in a managed care environment.
  • Must have experience supporting behavioral change, health promotion, coaching, and/or wellness initiatives.
  • Must have experience in strategy development, care management liaison roles, and interdisciplinary collaboration.
  • Must be proficient with Word, Excel, PowerPoint, and shared systems, and be able to troubleshoot and resolve general technical issues.
  • Must know regulatory standards and best practices related to behavioral health.
  • Must have a valid state driver's license and maintain personal vehicle liability insurance meeting the stated minimum limits or the higher applicable state requirement.
  • Must complete TB screening if selected for this patient-facing role.
  • Must meet the home-work internet requirements of at least 25 Mbps download and 10 Mbps upload and work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information.

Responsibilities

  • Develop behavioral health strategies across the enterprise, business, or segment to support best practices and processes that improve member outcomes.
  • Assess and evaluate member needs to help achieve and maintain optimal wellness.
  • Coordinate and apply strategies, approaches, and techniques to support members' psychosocial health needs as part of the Interdisciplinary Care Team.
  • Conduct member outreach and education related to behavioral health services.
  • Assess risk and determine appropriate care within individual member communities.
  • Collaborate with providers to support member care and service coordination.
  • Bridge gaps between the Health Plan, Prepaid Inpatient Health Plans, clinicians, and other Humana departments.
  • Support members' access to behavioral health services and resources.
  • Serve as the primary point of contact between community mental health centers/Prepaid Inpatient Health Plans and members receiving behavioral health services, helping ensure timely access to care and continuity of services.
  • Receive and review referrals from the interdisciplinary care team for members with behavioral health concerns who need support accessing services.
  • Connect members with Prepaid Inpatient Health Plans or other appropriate providers to support smooth and timely transitions of care.
  • Conduct outreach following referral outcomes, including service denials or unsuccessful contact, to address behavioral health needs and prevent gaps in care.
  • Partner with Special Needs Plan Care Coordinators and other care team members to address case management concerns and support coordinated member care.
  • Serve as a behavioral health subject matter resource for care management teams and internal stakeholders.
  • Coordinate Prepaid Inpatient Health Plans and internal teams to support integrated care and follow-up activities.
  • Analyze complex behavioral health cases and use sound judgment to identify appropriate care strategies and resource needs.
  • Monitor and manage follow-up activities related to referral dispositions, including unable-to-contact and denied-service outcomes.
  • Collaborate with interdisciplinary teams to identify and address behavioral health and broader care management needs.
  • Support integrated, member-centered care that promotes improved health and well-being.
  • Exercise independent decision-making and perform responsibilities effectively with minimal supervision.
  • Participate in community engagement and provider-relations activities, providing a behavioral health perspective at meetings and events with community organizations, provider groups, and advisory councils.
  • Provide telephonic and in-person care management for members with behavioral health concerns.

Desired Qualifications

  • Experience supporting patients telephonically.
  • Experience working in Community Mental Health, on a crisis response team, an Assertive Community Treatment team, and/or in substance use disorder treatment.
  • Experience working with both children and adults.

About the Company

Humana

Sells Medicare health plans and runs senior clinics

Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.

Company size
10,001+
Company stage
IPO
Headquarters
Louisville, KY
Founded
1961

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