Manager, Care Management – Behavioral Health

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

📋 Description

• Lead teams of nursing professionals and behavioral health specialists responsible for care management.

• Supervise the assessment and evaluation of members' behavioral health needs and requirements.

• Assist members and their families in navigating appropriate care and wellbeing resources.

• Make strategic decisions regarding resources, methodologies, and tactical operations for departmental projects and initiatives.

• Collaborate with other departments and conduct briefings and area meetings.

• Maintain regular communication with other department managers.

• Identify and address barriers that impede effective care delivery.

• Implement departmental, segment, and organizational strategies and operating objectives.

• Determine work methodologies and manage assignments with minimal supervision.

• Report directly to the Regional CM Associate Director.

• Contribute to the ongoing enhancement of consumer experiences.

⛳️ Requirements

• Unrestricted Registered Nurse (RN) license in South Carolina.

• Bachelor’s degree in Nursing (BSN) or a Licensed Master Level Clinician in psychology or social work (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT).

• Over 5 years of professional experience in Behavioral Health.

• At least 2 years of management experience.

• Minimum of 2 years of experience in Care Coordination/Case Management.

• Demonstrated proficiency in analyzing and interpreting data trends.

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

• Experience in coordinating services, care needs, or benefits for Medicaid and/or Medicare enrollees.

• Familiarity with NCQA, including leading re-accreditation efforts.

• Experience with NCQA, state audits, and external quality reviews (EQR).

• Previous work experience in a managed care environment.

• Over 5 years of management or supervisor-level experience.

• At least 3 years of clinical acute care experience in a behavioral health context.

• Certified Case Manager (CCM).

• Experience in utilization management.

• Availability to work Monday to Friday, from 8:00 a.m. to 5:00 p.m.

• A dedicated workspace that minimizes interruptions to protect member PHI/HIPAA information.

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

🏝️ Benefits

• 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.

• Bonus incentive plan.

• Remote work options.

• Occasional travel to Humana offices for training or meetings.

• Internet service requirements/support for home or hybrid employees.