Remote Care Manager, LCSW or Registered Nurse

Humana

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Location: OH
Location Type: Remote
Additional Location: OH; OH; OH; OH; OH;
Schedule: Full_time
Req: R-337681

Become a part of our caring community and help us put health first

The Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) assesses and evaluates member’s needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.

 

The Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Additional responsibilities for the BH CM are further defined by these two separate roles:

 

The BH CM must perform the full scope of care coordination activities and responsibilities for members who need care coordination and are not assigned to a Care Coordination Entity (i.e. the OhioRISE Plan, and/or a CME, or who choose to receive their care management from the MCO) and serves as the single point of contact for care coordination.  Or

 

The BH CM Plus must ensure the completion of the full scope of care coordination activities and responsibilities for members who need care coordination and are assigned to a Care Coordination Entity (i.e. the OhioRISE Plan, CPCs, and/or a CMEs). Care Manager Plus serves as the single point of contact for care coordination.

  • Ensuring the member receives the full scope of care coordination services, including comprehensive assessment completion (inclusive of the HRA), person-centered care plan completion, ensuring no duplication with the CCEs (Ohio RISE Plan, and/or CME), and identifying and addressing ongoing needs.
  • Providing actionable data, information, and support to assist the CCE, OhioRISE Plan, and/or CME in meeting the member’s care needs
  • Integrating information collected by the CCE into its Care Coordination Portal to minimize duplication

Position Responsibilities:

The Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) employs a variety of strategies, approaches and techniques to manage a member’s physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care.

 

  • 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.
  • Collaborates with providers and community services to promote quality and cost-effective outcomes.
  • Ensures the delivery of needed services/supports for Behavioral Health, Physical Health, Social Determinant of Health and value added benefits.
  • Coordinates across the transdisciplinary care team (at a minimum the PCP) and transitions of care
  • Submits incident reports

Use your skills to make an impact

Required Qualifications

  • Applicable state licensure in field of study with no disciplinary action: Licensed Masters Clinical Social Worker (LCSW), Clinical Social Worker (CSW), Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), or Registered Nurse (RN)
  • Minimum of 2 years of post-degree clinical experience in behavioral health setting
  • Case management experience
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Additional Requirements/Adherence

 

Workstyle: Combination remote work at home and onsite member facing

Location: Must reside in Ohio

  • Prefer Northeast Ohio

Hours: 40 hour work week Monday through Friday 8:00 AM 5:00 PM Eastern, over-time may be requested as business needs.

 

Travel: Must be willing to commute about 50% to meet with members. More information will be provided during the interview.

Remote Work at Home Requirements

  • Must have a separate room with a locked door that can be used as a home office to ensure absolute and continuous privacy during while you work
  • Must have accessibility to hardwired high speed internet with minimum speeds of 25Mx10M for a home office (Wireless and Satellite are prohibited)

Tuberculosis (TB) screening

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

Driver’s License, Transportation, Insurance This role is part of Humana’s Driver safety program and therefore requires an individual to have:

  • a valid state driver’s license,
  • proof of personal vehicle liability insurance with at least 100/300/100 limits,
  • and a reliable vehicle.

Preferred Qualifications:

  • Case Management Certification (CCM)
  • Experience working with Medicare, Medicaid and dual-eligible populations
  • Field Case Management Experience
  • Health Plan experience
  • Knowledge of community health and social service agencies and additional community resources
  • Experience with health promotion, coaching and wellness
  • Bilingual (Spanish, Somali or other)

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

 

You will be able to respond to the recruiters preferred response method via text, video or voice technologies  If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

 

Covid Compliance Policy

For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

  • Provide proof of full vaccination, including booster or commit to testing protocols

OR   

  • Provide proof of applicable exemption including any required supporting documentation

​​

Medical, religious, state and remote-only work exemptions are available.

 

 

Scheduled Weekly Hours

 

40

 

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$57,700 – $79,500 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

 

Equal Opportunity Employer

 

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.