Care Manager, Telephonic Behavioral Health

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

📋 Description

• Conduct telephonic assessments, evaluations, and support for members facing mental health challenges and complex medical issues.

• Educate and empower members to make informed healthcare choices.

• Offer guidance and clinical expertise to help navigate the healthcare system.

• Consult with members via telephone to ensure quality care.

• Direct members and their families towards suitable care and well-being resources.

• Collaborate with a multidisciplinary team to address physical, environmental, and psychosocial health concerns.

• Coordinate community care and services efficiently.

• Perform proactive telephonic outreach to eligible Humana members.

• Engage members in relevant care management programs.

• Conduct assessments covering physical, psychological, emotional, and environmental factors.

• Recommend and coordinate information, education, resources, referrals, and other necessary interventions.

• Collaborate with interdisciplinary team members, including social services, pharmacists, psychiatrists, utilization management teams, community health educators, and Employee Assistance Program (EAP) representatives.

• Utilize Motivational Interviewing and Solution-Oriented methodologies.

• Monitor member care and track progress towards achieving desired outcomes.

• Develop member care plans as required.

• Adhere to Humana's performance and reporting standards.

⛳️ Requirements

• Bachelor’s degree.

• A minimum of 3 years of experience as a Licensed Clinical Social Worker or Licensed Clinical Professional Counselor.

• Licensure in the relevant field within the state of Illinois without any disciplinary actions, or the ability to secure Illinois licensure.

• At least 1 year of managed care experience.

• A strong passion for enhancing consumer experiences.

• Preferred: Master’s degree in a behavioral health field such as social work, psychology, or a related health discipline from an accredited institution.

• Preferred: Bilingual in English/Spanish, English/Polish, or English/Creole, with the ability to speak, read, and write both languages fluently.

• Preferred: Certified Case Manager (CCM).

• Preferred: Experience in case management, discharge planning, and patient education for adult acute care.

• Preferred: Background in managed care.

• Preferred: Previous experience with Medicare and Medicaid recipients.

• Preferred: Proficiency in electronic case note documentation and various computer applications/systems.

• Preferred: Experience in health promotion, coaching, and wellness initiatives.

• Preferred: Familiarity with community health and social service agencies and available community resources.

• Home internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

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

🏝️ 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 home internet that meets minimum speed requirements.

• Remote work from a designated area that protects member PHI/HIPAA information.