The Manager, Care Management oversees the assessment and evaluation of 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 well-being of members.
- Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
- Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
- This role requires travel (After business travel restrictions are lifted) within Region 8 counties: Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota County.
The Manager, Care Management shall meet one of the following qualifications:
- Master’s Degree in human services, social sciences, or health related field with at least 2 years of case management experience with at least 1 year focused on elderly or disabled population.
- Bachelor’s Degree in a health related field with at least 5 years of case management experience with at least 1 year focused on the elderly or disabled population.
- 9 years of professional human service experience with a minimum of 5 years of case management experience with at least 1 year focused on the elderly or disabled population.
The Manager, Care Management shall meet all of the following qualifications:
- Leadership experience in the area of case management/care coordination.
- All Registered Nurses (RN) or Licensed Practical Nurses(LPN) must be licensed in the state of Florida without restrictions.
- Intermediate to advanced computer skills and experience with Microsoft Word, Excel and Outlook.
- Ability to work collaboratively with various departments, identifying and developing innovative processes.
- 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 100,000/300,000/100,000 limits.
- Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work.
- Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required.
- This role is considered patient facing and is a part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
- AHCA Fingerprint Required.
- Health Plan experience.
- Previous Medicare/Medicaid experience.
- Call center or triage experience.
- Previous experience in utilization management, discharge planning and/or home health or rehab.
- Prior nursing home diversion or long term care case management experience.
- Experience with health promotion, coaching and wellness.
- Experience working with the geriatric population.
- Bilingual a plus.
Direct Reports: Up to 15 Associates.
Travel: 25% travel within region 8 and in the state of Florida for meetings (After business travel restrictions are lifted).
Work Days/Hours: Monday – Friday; 8:30am – 5:00pm
Training: 4 weeks
As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours