About this role
# Become a part of our caring community
Humana Healthy Horizons is more than a health plan—we deliver human care. We help people achieve their best health by partnering with state and local governments, community-based organizations, and national partners to remove barriers to care and well-being.
In this South Carolina–based role, the Behavioral Health Case Manager assesses enrollees’ needs and helps individuals and families access the clinical, community, and social resources needed to achieve or maintain optimal wellness. This position primarily supports enrollees with complex and intensive health needs and coordinates person-centered care across telephonic and in-person settings.
You will report to Manager, Care Management Behavioral Health.
- Conduct telephonic and face-to-face assessments to evaluate each enrollee’s behavioral, physical, environmental, and psychosocial needs, and use a variety of care management strategies to support optimal health and well-being.
- Develop individualized, person-centered care plans; guide enrollees and families to appropriate clinical, community, and social resources; and collaborate with providers and community-based services to promote high-quality, cost-effective outcomes.
- Identify and resolve barriers to effective care, monitor progress through ongoing assessments and evaluations, and adjust interventions needed to help enrollees achieve desired outcomes.
- Collaborate with the interdisciplinary care management team, including community health workers, housing support specialists, and care management support assistants, to coordinate holistic support.
- Apply clinical expertise and professional judgment to determine when face-to-face support is appropriate, engage relevant care team members, and coordinate in-person meetings with enrollees when indicated.
- Interpret varied and complex information, independently determine appropriate courses of action, follow established guidelines and procedures, and align daily responsibilities with departmental, segment, and organizational strategies and operating objectives.
How You Will Make an Impact
You will use a collaborative, team-based approach to help ensure enrollees receive coordinated, holistic care that reflects their goals, preferences, and overall well-being.
Use your skills to make an impact
Required Qualifications
- Must Reside in South Carolin a
- Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker license (LCSW, LMSW, LPC, LMFT or similar) .
- Minimum 1-year Behavioral Health clinical experience
- 2 or more years of recent experience of case or care management
- Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
- Knowledge of community health and social service agencies and additional community resources
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
- Periodic travel to Humana Columbia office for meetings and training
Preferred Qualifications
- Experience working in Community Mental Health or as part of a crisis response team or Assertive Community Treatment (ACT) team, and substance use disorder treatment
- Experience working with both children and adults
Workstyle: This is a remote, field-based position serving members throughout an assigned South Carolina service area. The role requires a dedicated workspace that protects member privacy and complies with PHI and HIPAA requirements.
Travel: This role requires at least 50% local travel for face-to-face meetings and field-based interactions with enrollees, their families, providers, and staff.
Workdays and Hours: Monday–Friday, 8:00 a.m.–5:00 p.m.
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
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.
$65,000 - $88,600 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 us
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, at all levels of employment.