H

Humana

Sells Medicare health plans and runs senior clinics

Field Care Manager Behavioral Health

Full-Time
$65k - $88.6k/yr+ Bonus incentive
Mid
South Carolina, USA
RemoteMust reside in South Carolina. Requires at least 50% local travel and occasional office visits for meetings or training.
Social & Community ServicesCase Management & Advocacy

About the job

Requirements
  • Must reside in South Carolina.
  • Must hold an active Registered Nurse (RN) license or a Licensed Master Level Social Worker license (LCSW, LMSW, LPC, LMFT, or similar).
  • Must have at least 1 year of behavioral health clinical experience.
  • Must have at least 2 years of recent case or care management experience.
  • Must have experience working with Medicaid and/or Medicare enrollees to coordinate services, care needs, or benefits.
  • Must know community health and social service agencies and additional community resources.
  • Must have comprehensive knowledge of Microsoft Office applications, including Word, Excel, and PowerPoint.
  • Must maintain a dedicated workspace that protects member privacy and complies with PHI and HIPAA requirements.
  • Must meet minimum home internet speeds of 25 Mbps download and 10 Mbps upload.
  • Must be available to work Monday through Friday, 8:00 a.m. to 5:00 p.m.
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.
Desired Qualifications
  • Experience working in Community Mental Health or as part of a crisis response team or Assertive Community Treatment (ACT) team, and in substance use disorder treatment.
  • Experience working with both children and adults.

About the company

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, Kentucky

Founded

1961

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Simplify Jobs

Simplify's Take

What believers are saying

  • Enrollment is surging: in July 2026 Humana affirmed about 25% individual Medicare Advantage membership growth for 2026.
  • Owned clinics create clinical careers: CenterWell Senior Primary Care added 130,900 patients, up 27%, in early 2026.
  • Medicaid is widening: Illinois chose Humana in June 2026 to run Medicaid coverage statewide.

What critics are saying

  • Low quality scores cut Medicare bonuses: only 20% of Humana's members sat in 4-star or better plans for 2026.
  • The insurer is shrinking to save margins: about 600,000 Medicare Advantage members got plan-closure notices in October 2026.
  • Stock grants carry risk: in July 2026 Humana cut its 2026 GAAP earnings floor to $6.52 a share from $8.36.

What makes Humana unique

  • Military families are a second market: Humana runs the Pentagon's TRICARE health plan across 24 eastern states and Washington, DC.
  • Florida anchors the business: Humana's Medicare Advantage contracts there produced 14% of its 2025 revenue.
  • Medicaid is a quiet second insurer: Humana covers over 1.54 million low-income members across 11 states.

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance
  • Unlimited Paid Time Off
  • Paid Vacation
  • Paid Parental Leave
  • Short-term Disability
  • Long-term Disability
  • 401(k) Retirement Plan
  • 401(k) Company Match

Growth & Insights and Company News

6 month growth

6%

1 year growth

6%

2 year growth

6%
Yahoo Finance
Oct 20th, 2026
UnitedHealth and Humana raise drug costs 30% as older Americans face pricier Medicare

US insurers including UnitedHealth and Humana are cutting benefits for older clients and raising prescription drug costs for 2027, weeks before the midterm elections. Both insurers scrapped hundreds of plans and tightened coverage as older voters began choosing their plans. UnitedHealth and Humana raised maximum out-of-pocket costs by 11% and 8% respectively, according to investment bank Leerink. Both raised prescription drug coverage costs by about 30%. The changes affect 35 million Americans on Medicare Advantage plans, and the two firms hold about 46% of that market. The changes should help insurers' profits. UnitedHealth's healthcare division operating margin rose to 3.3% from 2.1% a year earlier, and Humana's shares are up 57% this year.

Yahoo Finance
Oct 9th, 2026
Humana soars 15% as 95% of Medicare members join four-star plans, beating analyst expectations

Humana shares surged 15% after the insurer announced 95% of its Medicare Advantage members will be in plans rated four stars or higher for 2027, up from just 20% a year ago. The result significantly exceeded J.P. Morgan analysts' expectations of 60% to 70%. Plans with four-star ratings or higher qualify for government bonus payments worth billions across the industry. The industry average for 2027 stands at roughly 71%. However, these ratings will determine bonus payments for 2028, not 2027. The improved ratings are particularly significant given Humana's thin margins. The company's EBIT margin has declined from 4.3% in 2023 to 2.3% on a last-twelve-months basis. Meanwhile, competitors moved in the opposite direction. UnitedHealth's four-star share is estimated to fall to approximately 67% from 81%, whilst CVS Health's drops to around 70% from 84%. CVS shares declined roughly 3%.

Yahoo Finance
Sep 13th, 2026
US health insurers rebound as medical costs stabilise, analysts predict 16% earnings growth through 2030

The health insurance industry may have recovered from high medical costs, with analysts predicting strong growth through 2030. Morningstar forecasts 16% annual earnings per share growth for major insurers, above the industry's typical low-double-digit target. Health insurers are improving profitability by raising rates to cover increased medical utilisation. UnitedHealth Group reported over $5 billion in second-quarter net income, with its medical care ratio falling to 86.7% from 89.4% year-over-year. The outlook also improved for pharmacy benefit management operations at companies like UnitedHealth, CVS Health, and Cigna. Despite increased regulatory scrutiny, the "big three" PBMs maintain strong competitive positions. Third-quarter earnings reports next month should provide further clarity on the industry's financial health.

PR Newswire
Sep 2nd, 2026
Thyme Care raises $125M at $2B+ valuation to expand oncology care model

Thyme Care, a Nashville-based oncology company, has closed a Series E funding round of more than $125 million at a valuation exceeding $2 billion. Morgan Health led the round, with participation from CVS Health Ventures, Humana, AlleyCorp, HealthQuest Capital, Foresite Capital, Concord Health Partners, Frist Cressey Ventures, Town Hall Ventures, and a16z Bio + Health. The company now serves over 10.5 million people across all 50 US states and manages more than $7 billion in oncology spend. Thyme Care reports it is profitable with positive free cash flow whilst delivering validated reductions of 5 to 10 per cent in total cost of care. Alongside the funding, Thyme Care is establishing Thyme Companies, a parent entity that will build a portfolio of independent oncology businesses addressing care barriers. Co-founder Robin Shah will serve as executive chairman of the new entity.

Associated Press
Aug 20th, 2026
Humana appoints Dr. Shantanu Nundy as chief medical officer to lead AI and digital care strategy

Humana has appointed Dr Shantanu Nundy as Chief Medical Officer, effective 31 August. Dr Nundy, a practicing physician and healthcare executive, will help shape the company's products, platforms, and use of AI whilst bringing clinical expertise to the enterprise. He most recently served as Executive Vice President of Care Delivery and Chief Health Officer at Accolade, a healthcare navigation company. Previously, he was Managing Director for Clinical Innovation at Evolent Health, driving value-based and digital care transformation across health systems. Dr Nundy will report to Jim Rechtin, Humana's President and CEO, and join the company's Enterprise Leadership Team. He continues to practice primary care and hospital medicine.