Field Care Manager Behavioral Health (Macomb & Wayne)

Become a part of our caring community

The Behavioral Health CM Liaison develops behavioral health strategies across the enterprise, business, or segment to support best practices and processes that improve member outcomes. This role works on problems of diverse scope and complexity, ranging from moderate to substantial.

The Behavioral Health CM Liaison develops behavioral health strategies that include mental health and substance use services. Responsibilities include assessing and evaluating member needs to help achieve and maintain optimal wellness. As a member of the Interdisciplinary Care Team, the Behavioral Health CM Liaison coordinates and applies a variety of strategies, approaches, and techniques to support members' psychosocial health needs.

This position supports Humana members' access to behavioral health services, with a focus on addressing the growing need for behavioral health care. Responsibilities include:

Conducting member outreach and education related to behavioral health services.

Assessing risk and determining appropriate care within individual member communities.

Collaborating with providers to support member care and service coordination.

Bridging gaps between the Health Plan, Prepaid Inpatient Health Plans (PIHPs), and clinicians across other Humana departments.

Supporting access to behavioral health services and resources for members.

Key Responsibilities

• Serve as the primary point of contact between Prepaid Inpatient Health Plans (PIHPs) and members receiving behavioral health services, helping ensure timely access to care and continuity of services.
• Receive and review referrals from Humana Behavioral Health for members with newly identified behavioral health needs.
• Connect members with PIHPs or other appropriate providers to support smooth and timely transitions of care.
• Conduct outreach to members following referral outcomes, including situations where services were denied or members could not be reached, to help address behavioral health needs and prevent gaps in care.
• Partner with Special Needs Plan Care Coordinators and other care team members to address case management concerns and support coordinated member care.
• Serve as a behavioral health subject matter resource for care management teams and internal stakeholders.
• Coordinate with Humana Behavioral Health, PIHPs, and internal teams to support integrated care and follow-up activities.
• Analyze complex behavioral health cases and use sound judgment to identify appropriate care strategies and resource needs.
• Monitor and manage follow-up activities related to referral dispositions, including unable-to-contact and denied-service outcomes.
• Collaborate with interdisciplinary teams to identify and address behavioral health and broader care management needs.
• Support integrated, member-centered care that promotes improved health and well-being.
• Exercise independent decision-making and perform responsibilities effectively with minimal supervision.
• Travel may include participation in community engagement and provider relations activities, providing a behavioral health perspective during meetings and events with community organizations, provider groups, and advisory councils.

Use your skills to make an impact

Required Qualifications

• Must reside in the State of Michigan with the ability to travel to Wayne and Macomb counties (15–20%).
• Active Michigan social work licensure in good standing, including one of the following: LPC , LLBSW, LBSW, LLMSW, LMSW, or LCSW . Limited license holders must demonstrate intent and active progress toward full licensure.
• 2+ years of experience in an integrated care setting supporting members with behavioral health and/or substance use needs, such as crisis services (including emergency room settings), community mental health centers, behavioral health inpatient settings, or Assertive Community Treatment (ACT) programs.
• Experience in a managed care environment.
• Experience supporting behavioral change, health promotion, coaching, and/or wellness initiatives.
• Experience in strategy development, care management liaison roles, and interdisciplinary collaboration.
• Proficiency with software applications, including Word, Excel, PowerPoint, and shared systems; ability to troubleshoot and resolve general technical issues.
• Knowledge of regulatory standards and best practices related to behavioral health.

Preferred Qualifications

• Experience supporting patients telephonically.
• Experience working in Community Mental Health, on a crisis response team, an Assertive Community Treatment (ACT) team, and/or in substance use disorder treatment.
• Experience working with both children and adults.

Additional Information

• Schedule:
• Initial Training: 4 weeks, Monday through Friday, 8:30 AM to 5:00 PM EST.
• Post-Training: 8-hour shift scheduled between 9:00 AM and 5:30 PM EST.
• Work Location: Michigan, with the ability to travel to Wayne and Macomb counties
• Work Style: Hybrid (80% remote / 20% field)
• Travel Requirements : Up to 20%, including travel to Wayne and Macomb counties

Driving Statement: This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

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

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$65,000 - $88,600 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.