Care Manager Licensed Behavioral Health Professional or Registered Nurse

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Job Information
Humana
Care Manager, Licensed Behavioral Health Professional or Registered Nurse
in
Canton
Ohio
Description
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.
Responsibilities
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
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, Central and Southeast 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 T
his 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

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