Care Management Manager

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Oversee teams comprising nurses, care coordinators, and behavioral health professionals focused on care management, transitions of care, and serving child/adolescent populations.

• Manage, guide, and assess a diverse range of healthcare professionals to guarantee effective care coordination.

• Foster cross-functional collaboration through regular updates and area meetings.

• Maintain communication with departmental managers to ensure alignment and operational efficiency.

• Identify members for involvement in case management and disease management initiatives.

• Supervise case management activities, including post-discharge calls, discharge planning, and pre-assessment for elective admissions.

• Generate system-wide recommendations, analyze trends, and implement strategies to manage those trends.

• Create audit plans and tools to ensure adherence to state contracts and performance metrics.

• Collaborate with leadership to develop reporting tools for assessing clinical performance.

• Conduct interviews, hire, mentor, evaluate, coach, and oversee performance for a diverse care coordination team.

• Facilitate onboarding for new associates, including pre-employment HR tasks and procurement of software, hardware, supplies, and support technologies.

• Monitor staff performance against service performance, utilization, and care coordination benchmarks.

• Travel across the state of Illinois up to 25% of the time.

⛳️ Requirements

• Possession of an active, unrestricted Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) license in Illinois; the license must be active within six months of hire.

• Experience working with children, adolescents, and within the foster care system.

• A minimum of five years of professional experience in the healthcare sector and/or care management.

• At least two years of leadership experience.

• Proficient in utilizing electronic information applications/software programs, including electronic medical records.

• Skillful in analyzing and interpreting data trends.

• Willingness to travel throughout Illinois up to 25% of the time.

• Valid state driver's license is required.

• Personal vehicle liability insurance that meets the minimum limits of the residing state or specified Humana limits, whichever is greater.

• Minimum home internet speed of 25 Mbps download and 10 Mbps upload.

• A dedicated workspace free from ongoing interruptions to safeguard member PHI/HIPAA information.

• Preferred: advanced degree in nursing, social services, psychology, or health business.

• Preferred: experience in managed care.

• Preferred: five or more years of management/supervisory experience, including hiring, training, mentoring, and coaching.

• Preferred: familiarity with STARS, HEDIS, or other healthcare quality measures and clinical program monitoring/evaluation.

• Preferred: knowledge of community health, social service agencies, and local resources.

• Preferred: bilingual or multilingual proficiency, including English/Spanish, Arabic, Vietnamese, Amharic, Urdu, or another language; must be able to speak, read, and write in both languages without restrictions or assistance.

• Patient-facing position requiring TB screening.

🏝️ Benefits

• Bonus incentive plan.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Self-provided internet service requirements for home or hybrid employees.

• Remote work from a dedicated space to protect member PHI/HIPAA information.