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 guidelinethis 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 / license
• 5 years or more prior nursing case management disease management and/or social work experience
• At least 2 years of team management experience
• Experience working in primary care acute care ambulatory care and or value-based care organizations
• Proficiency in analyzing and interpreting data trends
• Progressive business consulting and operational leadership experience
• Comprehensive knowledge in Microsoft office products
• Must be passionate about contributing to an organization focused on continuously improving customer experience
• Must provide a high-speed DSL or cable modem for home office
• Must have a separate room with a locked door that can be used as home office to ensure you have absolute privacy
• Driving 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.

$86300 - $118700 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 CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive preventive care to seniors including wellness visits physical exams chronic condition management screenings minor injury treatment and more. Our unique care model focuses on personalized experiences taking time to listen learn and address the factors that impact patient well-being. Our integrated care teams which include physicians nurses behavioral health specialists and more spend up to 50 percent more time with patients providing compassionate personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patients well-being.

About CenterWell a Humana company: CenterWell creates experiences that put patients at the center. As the nations largest provider of senior-focused primary care one of the largest providers of home health services and fourth largest pharmacy benefit manager CenterWell is focused on whole-person health by addressing the physical emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM) CenterWell offers stability industry-leading benefits and opportunities to grow yourself and your career. We proudly employ more than 30000 clinicians who are committed to putting health first for our teammates patients communities and company. By providing flexible scheduling options clinical certifications leadership development programs and career coaching we allow employees to invest in their personal and professional well-being all from day one.

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.