Care Manager – Tribal Health
Humana
full-time
Posted on:
Location Type: Remote
Location: Oklahoma • United States
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Salary
💰 $71,100 - $97,800 per year
About the role
- Performs telephonic and face to face assessments and evaluations of the member’s needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member.
- Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations.
- Creates member care plans.
- Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
- Employs a variety of strategies, approaches, and techniques to manage an Enrollee’s behavioral, physical, environmental, and psycho-social health needs.
- Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations.
- Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
- Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed.
- Follows established guidelines/procedures.
- Collaborates with providers and community services to promote quality and cost-effective outcomes.
- Periodic travel to Humana Oklahoma City office for meetings and training.
Requirements
- Must Reside in Oklahoma
- Experience working with Oklahoma-based tribal healthcare organizations.
- Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT)
- Minimum 1-year clinical experience
- 2 or more years of experience of care management
- Exceptional communication and interpersonal skills with the ability to quickly build rapport.
- Knowledge of community health and social service agencies and additional community resources.
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
- Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
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.
- Parental and caregiver leave.
- Employee charity matching program.
- Network Resource Groups (NRGs).
- Career development opportunities.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical experiencecare managementmember care plansassessmentsevaluationscommunity health knowledgesocial service knowledgeMedicaid experienceMedicare experience
Soft Skills
communication skillsinterpersonal skillsrapport buildingdecision makingproblem solving
Certifications
Registered Nurse (RN) licenseLicensed Master Level Social Worker (LCSW)Licensed Master Social Worker (LMSW)Licensed Clinical Social Worker (LMSW-ACP)Certified Social Worker (CSW)Licensed Professional Counselor (LPC)Licensed Marriage and Family Therapist (LMFT)