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Humana

Sells Medicare health plans and runs senior clinics

Field Care Manager Behavioral Health

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeSouth Carolina, USA

About the Job

Requirements

  • Must reside in South Carolina.
  • Must hold an active South Carolina social worker or counseling license: LMSW, LPC, LBSW, LISW-AP, or LISW-CP.
  • Must have at least 2 years of recent case or care management experience.
  • Must have experience working with Medicaid or Medicare enrollees to coordinate services, care needs, or benefits.
  • Must have knowledge of community health and social service agencies and additional community resources.
  • Must have a dedicated workspace that protects member privacy and complies with PHI and HIPAA requirements.
  • Must have home internet with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

Responsibilities

  • Conduct telephonic and face-to-face assessments to evaluate each enrollee's behavioral, physical, environmental, and psychosocial needs, and use care management strategies to support optimal health and well-being.
  • Develop individualized, person-centered care plans; guide enrollees and families to appropriate clinical, community, and social resources; and collaborate with providers and community-based services to promote high-quality, cost-effective outcomes.
  • Identify and resolve barriers to effective care, monitor progress through ongoing assessments and evaluations, and adjust interventions to help enrollees achieve desired outcomes.
  • Collaborate with the interdisciplinary care management team, including community health workers, housing support specialists, and care management support assistants, to coordinate holistic support.
  • Apply clinical expertise and professional judgment to determine when face-to-face support is appropriate, engage relevant care team members, and coordinate in-person meetings with enrollees when indicated.
  • Interpret varied and complex information, independently determine appropriate courses of action, follow established guidelines and procedures, and align daily responsibilities with departmental, segment, and organizational strategies and operating objectives.
  • Use a collaborative, team-based approach to help ensure enrollees receive coordinated, holistic care reflecting their goals, preferences, and overall well-being.
  • Travel at least 50% locally for face-to-face meetings and field-based interactions with enrollees, families, providers, and staff; occasional travel to Humana offices for training or meetings may also be required.

Desired Qualifications

  • Experience working in Community Mental Health, on a crisis response team or Assertive Community Treatment (ACT) team, 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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