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Humana

Sells Medicare health plans and runs senior clinics

Care Manager Telephonic Behavioral Health

Mental & Behavioral HealthConfirmed 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 license as a Licensed Professional Counselor, Licensed Independent Social Worker–Clinical Practice, or Licensed Independent Social Worker–Advanced Practice.
  • Must have at least one year of related work experience.

Responsibilities

  • Assess and evaluate members’ needs in a telephonic environment, guiding members and families toward appropriate resources for care and wellbeing.
  • Use strategies and techniques to manage members’ physical, environmental, and psychosocial health issues and resolve barriers to care.
  • Monitor care through assessments and evaluations to ensure members progress toward desired outcomes, and create member care plans as appropriate.
  • Support the Transition of Care program to ensure continuity of care as members move between care settings, such as from hospital discharge to home or outpatient care.
  • Assist with HEDIS completion follow-up visits after facility discharge for Transition of Care.
  • Conduct field visits based on member needs and program requirements.
  • Travel occasionally to support collaboration, conduct face-to-face meetings, and engage with staff, providers, members, and their families.

Desired Qualifications

  • A bachelor's or master's degree in a behavioral-health field, such as social work, psychology, or a related health discipline, from an accredited university.
  • One year of managed care experience.
  • Transition of care experience in physical health and/or behavioral health.
  • One year of inpatient behavioral health or case management experience in a hospital setting.
  • CCM certification.
  • Experience working with the Medicaid population.
  • Knowledge of community health and social service agencies and additional community resources.

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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