Manager, Care Management

This is a fully remote position, open to applicants in California, +4 more states.

📋 Description

• Oversee a team of care managers assisting members with transitional needs, chronic conditions, and obstacles impacting their health, independence, and overall well-being.

• Deliver operational leadership for telephonic, member-focused care management initiatives.

• Provide daily leadership, guidance, coaching, and development for designated care management associates.

• Set expectations, monitor performance, provide feedback, and document performance-related discussions.

• Manage associate performance in relation to quality, productivity, compliance, documentation, attendance, behavior, and member outcome expectations.

• Conduct individual meetings, team gatherings, call reviews, case discussions, and developmental conversations.

• Foster an engaged and inclusive team environment.

• Act as an escalation point for complex issues involving members, associates, operations, or processes.

• Support associates during process transitions, operational updates, system improvements, structured schedules, and changing priorities.

• Analyze operational and member outcome trends to uncover risks, barriers, coaching needs, and opportunities for process enhancement.

• Suggest actions to streamline workflows, improve outcomes, and align with business objectives.

• Communicate effectively with associates, peers, senior leadership, quality partners, workforce partners, and stakeholders across functions.

• Ensure audit preparedness and compliance with policies, procedures, documentation standards, privacy regulations, and quality expectations.

• Address concerns related to performance, attendance, behavior, quality, and compliance.

• Promote associate feedback, issue identification, and solution-driven recommendations.

• Exemplify Humana’s values and dedication to the success of both members and associates.

• Assist in onboarding, training, mentoring, and continuous education for telephonic care management associates.

⛳️ Requirements

• Active, unrestricted Registered Nurse license with no disciplinary history.

• A minimum of 5 years of case management experience.

• At least 2 years of direct or indirect leadership experience.

• Proficient in articulating ideas clearly in both written and verbal communication.

• Capable of analyzing performance, productivity, quality, audit, documentation, and operational data; recognizing trends and risks; and implementing action plans.

• Skilled in supporting change management, process enhancement, workflow updates, and operational initiatives.

• Extensive knowledge of Microsoft Office applications, including Word, Excel, PowerPoint, and Teams.

• Bachelor’s or Master’s degree in nursing, healthcare administration, business, or a related field is preferred.

• At least 3 years of previous management or supervisory experience is preferred.

• Ability to lead, coach, inspire, and hold associates accountable is preferred.

• Previous experience in a managed care environment is desirable.

• Minimum internet speed of 25 Mbps download and 10 Mbps upload for remote work.

• A separate room with a locked door available for use as a home office.

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

• Successful completion of Florida Level 2 background screening for candidates applying from a Florida work location.

🏝️ Benefits

• Bonus incentive plan based on individual and/or company performance.

• 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.

• Internet expense reimbursement for employees working from home in California, Illinois, Montana, or South Dakota.

• Provided telephone equipment.

• Remote work arrangement.

• Occasional travel to Humana offices for training or meetings.