Become a part of our caring community and help us put health first The individual in this role will work as an Oklahoma-based, primarily telephonic care manager, assessing and evaluating enrollees' needs and requirements to achieve or maintain optimal wellness by guiding enrollees/families towards and facilitating interaction with appropriate resources for their care and wellbeing. The individual in this role will work in collaboration with the interdisciplinary care management team. This team includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. The Care Manager, Telephonic Physical Health work assignments are varied but will focus on those enrollees with primarily physical health needs. The Care Manager, Telephonic Physical Health will utilize clinical expertise and experience to determine when face-to-face enrollee support is required, engaging the appropriate members of the care management team and/or coordinating in-person meetings between the care manager and the enrollee. This team-based approach is designed to ensure enrollees receive holistic person-centered care. Work assignments for this role are varied and frequently require interpretation and independent determination of the appropriate courses of action.
- 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.
- Employs a variety of strategies, approaches, and techniques to manage an Enrollee's behavioral, physical, environmental, and psycho-social health needs.
- Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations.
- Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
- Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed.
- Follows established guidelines/procedures.
- Collaborates with providers and community services to promote quality and cost-effective outcomes.
- Periodic travel to Humana Oklahoma City office for meetings and training.
Use your skills to make an impact Required Qualifications
- Must Reside in Oklahoma
- Candidates must have one of the following:
- Active Registered Nurse (RN) license (without restrictions)
- Licensed Clinical Social Worker (LCSW)
- Licensed Professional Counselor (LPC)
- Licensed Professional Clinical Counselor (LPCC)
- Licensed Marriage and Family Therapist (LMFT)
- Licensed Professional Art Therapist (LPAT)
- Minimum 1-year clinical experience
- 2 or more years of experience of in-home case or care management
- Exceptional communication and interpersonal skills with the ability to quickly build rapport.
- Knowledge of community health and social service agencies and additional community resources.
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
- Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
- This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
- This role is considered member facing and is part of Humana Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Preferred Qualifications:
- Proficiency in Spanish and English (Bilingual)
- Case Management Certification (CCM)
Work at Home Criteria
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. •Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
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.
$69,800 - $96,200 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 veteran status. 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.