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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management and coordination for child and adolescent populations, with a strong focus on compliance, performance metrics, and team leadership. Proficient in data analysis and electronic medical records, ensuring effective communication and operational efficiency across diverse healthcare teams.
Highest-signal resume keywords
Licensed Clinical Social Worker (LCSW)Care Management ExperienceLeadership ExperienceData Analysis ProficiencyElectronic Medical Records (EMR) Usage
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care CoordinationCase ManagementPerformance MonitoringAudit Plan DevelopmentTrend AnalysisDischarge PlanningPre-Assessment of Elective AdmissionsClinical Program MonitoringHealthcare Quality MeasuresCommunity Health Knowledge
Soft Skills
Team LeadershipMentoringCoachingEffective CommunicationCross-Functional Collaboration
Tools & Technologies
Electronic Information ApplicationsReporting ToolsHR SoftwareTelehealth TechnologiesPerformance Metrics Tools
Certifications & Qualifications
Licensed Clinical Professional Counselor (LCPC)Valid State Driver's LicensePersonal Vehicle Liability Insurance
Industry Keywords
Healthcare IndustryManaged CareChild/Adolescent PopulationsFoster CarePHI/HIPAA ComplianceCommunity ResourcesSocial Service AgenciesSTARSHEDISPatient-Facing Role
About the role
Key responsibilities & impact- Lead teams of nurses, care coordinators, and behavioral health professionals responsible for care management, transitions of care, and child/adolescent populations
- Supervise, direct, and evaluate diverse health care professionals to ensure effective care coordination
- Lead cross-functional collaboration through regular briefings and area meetings
- Maintain communication with departmental managers to ensure alignment and operational efficiency
- Identify members for case management and disease management activities
- Monitor case management activities, post-discharge calls, discharge planning, and pre-assessment of elective admissions
- Develop system-view recommendations, report trends, and implement actions to control trends
- Develop audit plans and tools to ensure compliance with state contracts and performance metrics
- Develop reporting tools with leadership to identify clinical performance
- Interview, hire, mentor, evaluate, coach, and manage performance for a diverse care coordination team
- Onboard new associates, including pre-employment HR tasks and ordering software, hardware, supplies, and support technologies
- Monitor staff performance against service performance and utilization and care coordination benchmarks
- Travel throughout the state of Illinois up to 25%
Requirements
What you’ll need- Active, unrestricted Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) license in Illinois; license must be active within 6 months of hire
- Experience with children, adolescents, and foster care populations
- Five or more years of professional experience in the health care industry and/or care management
- Two or more years of leadership experience
- Ability to use electronic information applications/software programs, including electronic medical records
- Proficiency in analyzing and interpreting data trends
- Ability to travel throughout Illinois up to 25%
- Valid state driver's license
- Personal vehicle liability insurance meeting the residing state's minimum limits or specified Humana limits, whichever is higher
- Minimum home internet speed of 25 Mbps download and 10 Mbps upload
- Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information
- Preferred: advanced degree in nursing, social services, psychology, or business health
- Preferred: managed care experience
- Preferred: five or more years of management/supervisor experience, including hiring, training, mentoring, and coaching
- Preferred: experience with STARS, HEDIS, or other healthcare quality measures and clinical program monitoring/evaluation
- Preferred: knowledge of community health, social service agencies, and community resources
- Preferred: bilingual or multilingual ability, including English/Spanish, Arabic, Vietnamese, Amharic, Urdu, or another language; must speak, read, and write both languages without limitations or assistance
- Patient-facing role requiring TB screening
Benefits
Comp & perks- Bonus incentive plan
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Self-provided internet service requirements for home or hybrid employees
- Remote work from a dedicated space to protect member PHI/HIPAA information