Become a part of our caring community and help us put health first
 

The Manager Care/Case Management is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high needs patients using a team-based approach to ensure patients receive the individualized care and services they need to reach optimal health. The Manager is also responsible for building strong partnerships with clinical-operational market leaders on Care Integration Team foundational program and strategic opportunities for managing populations and coordinating care to reduce acute and post-acute care utilization. The Manager role is hybrid with travel requirements to preferred healthcare facilities in the community, alongside clinical market leader, to develop clinical partnerships for timely access to patient information, clinical collaboration on patient care, and patient centered resources.

As a guideline, this role involves spending 50% of the time on operational excellence and program delivery, 25% on relationships, and 25% on community partnerships.

Major Duties and Responsibilities

Oversees day-to-day operations, quality chart audit reviews, recruiting/hiring, team management, and overall performance for Care Integration Team associates in the market.Ensures clinical program integrity at the market level and addresses performance and program improvement opportunities, escalating to Divisional Director as appropriate.Collaborates with market leader/key stakeholders to design market specific strategies, data analytics, and create action plans that will reduce acute and post-acute care utilization. Solicits/shares feedback with market leaders on team-based focus with attention given to success and opportunities to improve one care team culture and collaboration on high-risk patient management, at the market level. Effectively prioritizes patients with the market leaders who benefit the most from care management programs.Initiates and maintains relationships with community partners, including key community organizations, Centerwell organizations (home health and pharmacy), and health care systems for strong clinical collaboration that will improve patient experience and overall population health outcomes.Accountability to key population health metrics, including quality, utilization and financial measures.
Use your skills to make an impact
 

Required Qualifications

A current unrestricted state RN license or Social Work degree / license5 years or more prior nursing, case management, disease management and/or social work experienceAt least 2 years of team management experienceExperience working in primary care, acute care, ambulatory care and or value-based care organizationsProficiency in analyzing and interpreting data trendsProgressive business consulting and operational leadership experienceComprehensive knowledge in Microsoft office productsMust be passionate about contributing to an organization focused on continuously improving customer experienceMust provide a high-speed DSL or cable modem for home officeMust have a separate room with a locked door that can be used as home office to ensure you have absolute privacyDriving required to community organizations, health systems, and CW centers

Preferred Qualifications

Bilingual in English/Spanish with the ability to speak, read and write in both languages without limitations and assistance

Additional Information

Hybrid Office Workstyle: Combination in home office work and local travel to clinics

Benefits

Health benefits effective day 1

Paid time off, holidays, volunteer time and jury duty pay

Recognition pay

401(k) retirement savings plan with employer match

Tuition assistance

Scholarships for eligible dependents

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.

 

$86,300 - $118,700 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
 About Conviva: Conviva Care Centers provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of Humana’s Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our 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, 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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.