Field Care Manager, Behavioral Health

Field Care Manager, Behavioral Health

Humana is looking for a Field Care Manager, Behavioral Health to join the IL Medicaid team. In this position, you will report to the Manager, Care Management and connect with members both face-to-face and telephonically. 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 needs. You will employ a variety of strategies, approaches, and techniques to manage a member's health issues and resolve barriers that hinder effective care. Using a holistic, person-centered approach, you will enhance behavioral health outcomes, reduce care gaps and support Illinois' FIDE population through 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), Substance Use Disorders (SUD) and justice-involved members.
• Engage members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination.
• 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.
• Serve as the driver of the member's interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery.
• Facilitate ICT meetings, ensuring communication among providers, Service Coordinators, and Care Management Extenders.
• Proactively support transition of care efforts.
• Will work with autonomy but reach out when support is needed.
• Collaborate 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.
• Follow processes and procedures to ensure compliance with regulatory requirements by the Illinois Department of Human Services (IDHS), Center for Medicare and Medicaid Services (CMS) and the National Committee on Quality Assurance (NCQA).
• Travel up to 25% within Illinois

Required Qualifications:

• Applicants must reside in Cook or Kane County, IL, within one of the following ZIP codes, or within a 10-mile radius of these Zip Codes: 60004, 60005, 60008, 60010, 60016, 60018, 60025, 60026, 60043, 60053, 60056, 60062, 60067, 60070, 60074, 60076, 60077, 60090, 60091, 60107, 60169, 60173, 60192, 60193, 60194, 60195, 60201, 60202, 60203, 60656, 60714, 64646, 60093
• Active Illinois license in LCSW, LMFT or LCPC (No supervisees or provisional licenses)
• 2+ years of post-degree clinical experience in behavioral health setting.
• Case management experience working with complex SMI, SUD, SED population.
• Ability to travel to region-based facilities and homes for face-to-face assessments.
• 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.
• Valid driver's license, car insurance, and reliable transportation.

Preferred Qualifications:

• Case Management Certification (CCM)
• 3+ yearss of experience with children, adolescence and foster care populations or transition of care/discharge planning experience
• 3+ years of in-home assessment or care coordination experience.
• Experience working with Medicare, Medicaid and dual-eligible populations
• Field Case Management Experience
• Knowledge of community health and social service agencies and additional community resources
• Previous managed care experience
• Bilingual

Additional Information:

• Workstyle: This is a remote position that will require you to travel.
• Travel: Up to 25% of the time for collaboration and face-to-face meetings and field interactions with staff, providers, members, and their families.
• Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Central Standard Time (CST).

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.

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.

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 $71,500 - $97,500 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 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