Manager, Care Management

Become a Part of Our Caring Community and Help Us Put Health First

Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health professionals responsible for care management. The Manager, Care Management, works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.

The Manager, Care Management supervises, directs and evaluates a diverse group of health care professionals to assure effectiveness of care coordination activities.

Responsibilities include :

• Leads cross-functional collaboration through regular briefings and area meetings; maintains ongoing communication with departmental managers to ensure alignment and operational efficiency.
• Identify members for specific case management and / or disease management activities.
• Monitors case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions.
• Develop system-view recommendations, reports trends and implement appropriate actions to control trends.
• Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met.
• Develop reporting tools in collaboration with leadership to identify clinical performance.
• Interviews, hires, mentors, evaluates, coaches and manages performance for a diverse care coordination team.
• Onboards new associates including but not limited all pre-employment human resource tasks, ordering software, hardware, supplies and support technologies.
• Monitors performance of staff including service performance and adherence to established utilization and care coordination benchmarks.

Required Qualifications :

Preferred Qualifications :

Additional Information :

Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours : 40

Pay Range : $86,300 - $118,700 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.

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.