Manager Care Management Illinois Medicaid - The Greater Chicago Area

Profile

Job Information

Humana

Manager, Care Management (Illinois Medicaid) - The Greater Chicago Area

in

Chicago

Illinois

Description

The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

Humana Benefits - How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Responsibilities

The Manager, Care Management supervises, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordinators activities. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross-departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.

Develop system-view recommendations.

Report trends.

Implement appropriate actions to control trends.

Develop audit plans and tools for teams to ensure compliance with state contract on performance metrics and to ensure member needs are met.

Develop reporting tools in collaboration with leadership to identify clinical performance.

Interviewing, hiring, disciplining, evaluating and mentoring a diverse care coordination work force.

Onboard new staff including but not limited all pre-employment human resource tasks, ordering of software, hardware, supplies and support technologies.

Monitor performance of staff including service performance and adherence to establish utilization and care coordination benchmarks.

Identify members for specific case management and / or disease management activities.

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

Requires travel, 50 - 75% of the time.

Required Qualifications

Bachelor Degree with an active Registered Nurse (RN) license or Master Social Worker with license in state of Illinois without restrictions.

5 or more years of professional experience.

2 or more years of leadership experience.

Prior experience in health care industry/setting and/or case management.

Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint.

Ability to use a variety of electronic information applications/software programs including electronic medical records.

Proficiency in analyzing and interpreting data trends.

Work At Home Requirements

Must have a separate room with a locked door that can be used as a home office to ensure you and your members have absolute and continuous privacy while you work.

Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.

Screening Requirements

We will require full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve. This job must be in the office and requires close personal interaction with patients. You will not be able to social distance.

If progressed to offer, you will be required to provide proof of full vaccination where allowed by law. Medical and religious exemptions will be considered on a case by case basis. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.

This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Preferred Qualifications

Advanced degree in nursing or business health field

Certified Case Manager (CCM)

Previous experience working in a managed care field

5 or more years of previous management/supervisor level experience.

Prior experience with healthcare quality measures STARS, HEDIS, etc. and/or clinical program monitoring/evaluation.

Knowledge of community health and social service agencies and additional community resources.

Additional Information

Direct Reports:

Up to 15 Associates.

Hours:

T

ypically Monday-Friday 8:00 AM - 5:00 PM (flexible with schedule if needed) with rotating on-call/oversight during weekends and holidays.

Work Location and Travel:

Considered primarily remote/work at home (WAH) position, but will require travel 50% - 75%.

Must be able to travel occasionally to Humana's office location.

This role is a part of Humana's Driver Safety program and therefore requires and individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,00 limits.

Onsite Travel

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.

#ThriveTogether #WorkAtHome

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Modern Hire Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed)

inviting you to participate in a Modern Hire Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com