Description
Humana Gold Plus Integrated is seeking a Manager, Care Management to lead teams of nurses, care coordinators, and behavioral health professionals responsible for care management.
The Manager, Care Management, works within specific guidelines and procedures, applying advanced technical knowledge to solve moderately complex problems. They receive assignments in the form of objectives and determine approach, resources, schedules, and goals.
Key responsibilities include:
- Leading cross-functional collaboration through regular briefings and area meetings
- Identifying members for specific case management and disease management activities
- Monitoring case management activities, post-discharge calls, discharge planning, and pre-assessment of elective admissions
- Developing system-view recommendations, reporting trends, and implementing actions to control trends
- Interviewing, hiring, mentoring, evaluating, coaching, and managing performance for a diverse care coordination team
Requirements:
- Active, unrestricted Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW), or Licensed Clinical Professional Counselor (LCPC) in Illinois
- Five or more years of professional experience working in the healthcare industry and/or in care management
- Two or more years of leadership experience
- Ability to use electronic information applications/software programs, including electronic medical records
- Proficiency in analyzing and interpreting data trends
- Ability to travel throughout Illinois
Preferred qualifications:
- Advanced degree in nursing or business health field
- Certified Case Manager (CCM)
- Previous experience working in a managed care field
- Prior experience with healthcare quality measures (STARS, HEDIS, etc.) and/or clinical program monitoring/evaluation
- Knowledge of community health and social service agencies and additional community resources
- Bilingual or multilingual (English/Spanish, Arabic, Vietnamese, Amharic, Urdu, etc.)
Benefits:
- Competitive medical, dental, and vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance
Salary range: $94,900 - $130,600 per year This role is eligible for a bonus incentive plan based on company and/or individual performance.