Manager, Care Management – RN or SW

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

📋 Description

• Lead teams of nursing and behavioral health professionals responsible for managing patient care.

• Supervise the assessment and evaluation of members' needs to ensure optimal wellness is achieved or maintained.

• Direct members and their families towards suitable care and wellness resources.

• Collaborate with various departments and facilitate briefings and area meetings.

• Maintain regular communication with other department managers.

• Oversee the provision of care to all members served by the facility.

• Review member case information to ascertain assessment requirements and necessary disciplines.

• Monitor staff performance, service delivery, and compliance with care coordination benchmarks.

• Identify members eligible for case management and disease management programs.

• Create audit plans and tools to ensure adherence to state contract performance metrics and member needs.

• Develop reporting tools in conjunction with leadership to monitor clinical performance.

• Interview, hire, coach, assess, and mentor a diverse workforce in care coordination.

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

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

• Travel within Wayne and Macomb Counties for field-based interactions, up to 50%.

⛳️ Requirements

• Must reside in Michigan and be willing to travel to Wayne County or Macomb County.

• Active Registered Nurse (RN) license or Social Work (SW) license in Michigan is required.

• 3+ years of professional experience as a licensed RN or Social Worker, including case and/or disease management experience.

• At least 1 year of leadership and people management experience in a home care, hospice, or similar field-based healthcare environment.

• Proven experience in coaching, supporting, and developing clinicians in a dynamic healthcare setting.

• Strong ability to analyze and interpret data trends.

• Comprehensive proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint.

• An Associate's Degree is preferred.

• Certification as a Case Manager (CCM) is preferred.

• 3+ years of prior management or supervisor-level experience is preferred.

• Experience with Medicaid Long Term Care is preferred.

• Fully bilingual in English and Spanish or Arabic is preferred.

• Ability to undertake the Interagency Language Rating (ILR) test if communicating with members in a language other than English.

• TB screening must be completed if selected.

• A valid state driver's license is required.

• Must maintain personal vehicle liability insurance that meets the stated minimum requirements.

• Must meet home internet and dedicated workspace standards.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability insurance.

• Life insurance coverage.

• Support for personal wellness and smart healthcare decisions.

• Eligible mileage reimbursement for travel between home and work locations, client or assignment locations, and from the final work location back home.

• Option for a home office work arrangement.

• Occasional travel to Humana offices for training or meetings.

• Self-provided internet service must meet minimum speeds of 25 Mbps download and 10 Mbps upload.

• A dedicated workspace is required to protect member PHI/HIPAA information.