Care Manager, Behavioral Health

Humana

1d • Remote

About The Position

Become a part of our caring community and help us put health first The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' 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 Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 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. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact

Requirements

• Master’s degree in social work from an accredited university
• Current, unincumbered, social work license (LMSW, LCSW, or LICSW).
• Must have passed ASWB Exam (Master, Advance Generalist, or Clinical level).
• Minimum 3 years of experience working as a social worker in a medical healthcare setting.
• Proficient in Microsoft applications including Word, Outlook, Excel
• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
• Must be willing to obtain/maintain social work licensure in multiple states, based on business need.
• You must have a separate room with a locked door that can be used as a home office to ensure continuous privacy while you work.
• High-speed DSL or cable modem for a home office (minimum: 25 Mbps download / 10 Mbps upload). Satellite and wireless internet services are NOT permitted.
• Dedicated workspace to maintain confidentiality of PHI/HIPAA information.

Nice To Haves

• Experience working with geriatric, vulnerable, and/or low-income populations
• Licensure in AL, AR, IN, LA, MO, MS, NC, OK, SC, or WA
• Bilingual English/Spanish or English/Creole
• Experience working with Medicare and Medicaid

Responsibilities

• Serve as a Licensed, Master’s-level Social Worker within the Special Needs Plan (SNP) program, functioning as a Support Social Services associate and interdisciplinary care team member.
• Conduct telephonic outreach to members with social determinants of health (SDOH) needs to assess, support, and coordinate care using plan benefits and community resources.
• Utilize structured assessments and critical thinking to determine appropriate interventions, including care coordination, health education, resource connection, and advocacy.
• Collaborate with interdisciplinary team members (e.g., nurse care managers, dietitians, behavioral health, pharmacists), providers, and community partners to address member needs.
• Handle both outbound and inbound member interactions in a fast-paced, telephonic, work-from-home environment; perform follow-up as needed to ensure all needs are addressed.
• Assess members for additional support needs and initiate referrals to appropriate disciplines based on individualized circumstances.
• Develop, update, and maintain member care plans as needed to support ongoing care coordination.
• Document all interactions and care activities accurately in the member record to ensure CMS compliance and reflect engagement with members and care teams.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees