Care Manager, Telephonic Behavioral Health

Humana · United States

Become a part of our caring community 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. Follows established guidelines/procedures.

• Humana is seeking a Care Manager, Telephonic Behavioral Health 2 to telephonically assess, evaluate, and support members who are challenged by both mental illness and complex medical situations. Our goal is to provide support for both mind and body to allow each member to achieve and/or maintain their optimal health.
• Apply your clinical knowledge to educate and empower your members, to take charge of their own healthcare decisions. Provide guidance and clinical expertise on how to navigate through the health care setting. Provide ongoing consultation with members via telephone to ensure that they are receiving the best quality of care possible. You will guide members and their families toward and facilitate interaction with resources appropriate for their care and wellbeing. You will work in collaboration with a multi-disciplinary team, employing a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Coordinate community care and services as deemed appropriate. Comply with performance and reporting standards as defined by Humana.

• Proactive telephonic outreach to eligible Humana members and engage participation in appropriate care management programs
• Complete physical, psychological, emotional and environmental assessments, to provide appropriate, interventions to ensure provision of optimal care
• Based on identified needs, recommend and coordinate interventions that may include information, education, resources and referrals
• Coordinate community care and services as deemed appropriate
• Work with other members of the Interdisciplinary team - to include; LAL, IHWA, Social Services, Pharmacists, Psychiatrists, Utilization Management teams, Community Health Educators, EAP and others if appropriate
• Comply with performance and reporting standards as defined by Humana Corporation
• Use Motivational Interviewing and Solution-Oriented approaches in communication with members
• The working hours for this position are between 8:00am-7:00pm central standard time; but core hours are 8:00am-5:00pm central standard time.

• Bachelor's degree
• 3+ years of experience working as a Licensed Clinical Social Worker or Licensed clinical Professional Counselor
• Licensure in field of study within the state of Illinois with no disciplinary action or can obtain IL licensure.
• 1 year of managed care experience
• Must be passionate about contributing to an organization focused on improving consumer experiences

• Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university
• Bilingual in English/Spanish, English/Polish, or English/Creole. Can speak, read, and write in both languages without limitations or assistance. See Additional Information on testing.
• Certified Case Manager (CCM)
• Experience with case management, discharge planning and patient education for adult acute care
• Managed care experience
• Prior experience with Medicare & Medicaid recipients
• Previous experience with electronic case note documentation and experienced with documenting in multiple computer applications/systems
• Experience with health promotion, coaching and wellness
• Knowledge of community health and social service agencies and additional community resources