Field Care Manager - BH

Join Our Caring Community

The Field Care Manager, Behavioral Health performs primarily face to face and telephonic assessments with members. The Field Care Manager serves as the primary point of contact, providing integrated care to ensure members receive timely, high-quality, and coordination services that meet their unique needs. This position employs a variety of strategies, approaches, and techniques to manage a member's health issues and identifies and resolves barriers that hinder effective care. Through a holistic, person-centered approach, the BH Care Manager remains dedicated to enhancing behavioral health outcomes, reducing care gaps, and supporting Virginia's Medicaid population with comprehensive, integrated behavioral health care management.

Position Responsibilities:

• Utilize high-quality, evidence-based behavioral health services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical and behavioral health providers.
• Provide comprehensive, integrated support to members experiencing behavioral health conditions, including children, adolescents, adults with serious mental illness (SMI) and serious emotional disturbance (SED), and justice-involved members.
• Engages members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination.
• Complete all required assessments, including the Comprehensive Risk Assessment (CHRA).
• Coordinate behavioral health and medical services, ensuring appropriate provider engagement and adherence to treatment plans.
• Improve member's health literacy while simultaneously addressing health related social needs to positively impact member's healthcare outcomes and well-being.
• Serving as the quarterback of the member's interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery.
• Facilitating ICT meetings, ensuring seamless communication among providers, Service Coordinators, and Care Management Extenders.
• Engaging in biannual and quarterly face-to-face visits, ensuring continuous monitoring and proactive intervention.
• Must be able to work with autonomy but reach out when support is needed.
• Collaborates with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members' preferences and needs.
• Will follow processes, and procedures to ensure compliance with regulatory requirements by the Virginia Department of Medical Assistance Services (DMAS), Center for Medicare and Medicaid Services (CMS) and the National Committee on Quality Assurance (NCQA).

Use Your Skills To Make An Impact

Required Qualifications:

• Bachelor's degree in social work, psychology or other health or human services related field
• Virginia licensed LMHP, LPC or LCSW (No supervisees or provisional licenses)
• Minimum of 2 years of post-degree clinical experience in behavioral health setting
• Case management experience working with complex SMI or SED population
• Must reside in Virginia; This role will be regionally based in Northern/Winchester, Southwest and Virginia Beach areas
• Ability to travel to region-based facilities and homes for face-to-face assessments.
• Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport
• Ability to work with minimal supervision within the role and scope
• Ability to use a variety of electronic information applications/software programs including electronic medical records
• Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel
• Ability to work a full-time schedule
• Valid driver's license, car insurance, and reliable transportation.

Preferred Qualifications:

• Case Management Certification (CCM)
• 3-5 years of in-home assessment and care coordination experience
• Experience working with Medicare, Medicaid and dual-eligible populations
• Experience working with high risk pregnant and post-partum population with BH needs
• Field Case Management Experience
• Knowledge of community health and social service agencies and additional community resources
• Previous managed care experience
• Bilingual preferred (Spanish, Arabic, Vietnamese or other)

Additional Information:

• Workstyle: This is a remote position that will require you to travel.
• Travel: Up to 25% of the time to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as field interactions with staff, providers, members, and their families.
• Workdays and Hours: Monday Friday; 8:00am 5:00pm Eastern Standard Time (EST).
• Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Interview Format:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Scheduled Weekly Hours 40

Pay Range: $59,300 - $80,900 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

Humana Inc. (NYSE: HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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.