Field Care Manager, Behavioral Health

Field Care Manager, Behavioral Health

Join Humana as a Field Care Manager, Behavioral Health supporting the WI Medicaid market. As a Field CM BH, you will assess and evaluate members' needs to support optimal health and wellness. In addition, you will guide members and their families in accessing appropriate behavioral health and community resources and facilitate care coordination and engagement across the continuum. You will also work to close HEDIS measure gaps through proactive outreach, education, and coordination with providers and members to improve quality outcomes and ensure compliance with care standards.

Responsibilities include:

• Perform all responsibilities according to the DHS contract for Medicaid Managed Care Organizations, specifically regarding the Wisconsin Interdisciplinary Care Team (WICT).
• Identify the appropriate treatment needs, level of service and referral sources for members with medical, psychiatric, and substance abuse diagnoses and facilitate their implementation.
• Conduct visits in the community to complete monthly face-to-face requirements, including health risk assessments, with identified members and help develop care plans appropriate to the identified treatment goals.
• Coordinate necessary services with ancillary providers and community agencies to ensure member stabilization within the community.
• Meet weekly with the interdisciplinary team to collaborate and provide updates on the entire WICT caseload.
• Contribute to the development of department strategy and refinement of programs, policies, procedures, and quality improvement (QI) projects.
• Serve as a consultative resource for other care management staff.
• Educate members on preventive health guidelines and programs including HEDIS gap closures.
• Lead special projects.

Required qualifications include:

• Master's degree.
• Applicable WI State licensure as a Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC).
• 2 years of case management experience.

Preferred qualifications include:

• Bilingual in English/Spanish.
• Previous experience working in a Managed Care Organization.
• Previous experience with Medicare & Medicaid recipients.

Additional information includes:

• Work location: must reside in Wisconsin in the Milwaukee or Madison metro areas.
• Travel: 25 - 50% of the time to see members in the community.
• Typical workdays/hours: Monday - Friday, 8:30am - 5pm CST.

Driving requirements include:

You will be part of Humana's driver safety program and therefore requires you to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. Mileage reimbursement is provided for work-related travel.

TB screening is required for this role as it is considered patient facing.

Home or Hybrid Home/Office employees must meet internet requirements.

HireVue is used as part of the hiring process.

Scheduled weekly hours: 40

Pay range: $65,000 - $88,600 per year

This job is eligible for a bonus incentive plan.

Description of benefits includes medical, dental, vision benefits, 401(k) retirement savings plan, time off, disability, life insurance, and many other opportunities.

About Humana: Humana Inc. 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.

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.