Care Manager, Telephonic Behavioral Health 2 - Remote, US

Humana Inc. Rogers , AR 72757

Posted 2 months ago

Description

Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their families. For more than 20 years, Humana Military has strived to create better health outcomes and simplified experiences for millions of beneficiaries across the United States through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches to care drive Humana Military to be a thought leader in the industry and an essential partner to the Government.

Responsibilities

The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Behavioral Health Disease Management programs throughout the continuum of care. They will have personal interaction with beneficiaries to address behavioral health conditions identified through Predictive Analytics helping them develop healthy behaviors, understand their condition/disease, coping skills and treatment plan adherence; leading to decreased risk of progression into a disease and symptoms and complications of the condition/disease. The care manager will assess, plan, coordinate, implement, monitor, and evaluate the care of each beneficiary required to meet the health needs of TRICARE beneficiaries, to maximize each beneficiary's capacity for self-care to enhance quality of behavioral health care and achieve desired clinical outcomes.

As part of the Care Management Team, the care manager will serve as the primary coordinator and point of contact for the beneficiary for all activities within the clinical spectrum. This will include coordination and collaboration within the Care Management programs, Military Treatment Facility (MTF) UM/CM/DM staff, physicians or providers to ensure there is a fully integrated care plan addressing all beneficiary needs and conditions; documenting interventions and outcomes for beneficiaries within the Care Management program. Performs all duties within the scope of his/her licensure.

  • Provide telephonic care guidance support to beneficiaries and their family/caregiver to ensure education, care coordination and support measures are in place; according to the established plan of care.

  • Assess beneficiary needs and develop a personalized plan of care from the assessment findings; in coordination with the beneficiaries' physician.

  • Conduct assessments to identify gaps in care, eligibility for assistance and/or need for care management program or other referral services in collaboration with Humana Government Business.

  • Utilize Motivational Interviewing and solution-oriented approaches in communication delivery.

  • Identify Social Determinants of Health needs and/or community resources to provide services.

  • Maintain beneficiary's privacy, confidentiality and safety, advocacy, adherence to ethical, legal, and accreditation/regulatory standards during this process.

  • Ensure adherence to policies and performance standards in accordance with the URAC, TRICARE Operations Manual (TOM), TRICARE Provider Manual (TPM) or any other Defense Health Agency (DHA) directives.

  • Adhere to URAC standards, state and federal regulations and individual licensing boards.

  • Participate in professional development activities to include current principles, procedures, and knowledge domains of case management based on nationally recognized standards and licensure requirements.

  • Attend and participate in Care Management quality management/performance improvement activities.

  • Performs all duties within the scope of her/his licensure and other tasks as assigned.

Our Department of Defense Contract requires U.S. citizenship for this position.

Required Qualifications

  • Active LCSW (Licensed Clinical Social Worker), LMHC (Licensed Mental Health Counselor), LPC (Licensed Professional Counselor), LMSW (Licensed Master Social Worker) or RN Licensure in state of employment.

  • Case Management Certification (CCM) required.

  • Master's degree in Mental Health Field (Social Work, Counseling or related field) or Bachelor's degree in nursing.

  • 3-5 plus years clinical or managed care experience.

  • Experience in managing mental health crisis intervention.

  • Proficient with Microsoft Office Excel & Word.

  • Excellent communication skills, verbal and written.

  • Excellent organizational skills.

  • Our Department of Defense Contract requires U.S. citizenship for this position.

  • Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation.

  • Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10-panel drug test.

Work at Home Requirements

  • Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work.

  • Must provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.

Preferred Qualifications

  • Bilingual - English, Spanish.

  • Experience with Behavioral Health/Chronic Care Disease management programs.

  • Experience with motivational interviewing techniques.

  • Direct or Indirect Military experience a plus.

Additional Information

The following policy applies ONLY to associates working in the state of Arizona: Humana is committed to providing a safe and healthy work environment and to promoting the health and well-being of its associates. Effective July 1, 2011, Humana adopted a tobacco-free hiring policy that will promote a healthier workplace and will not hire users of tobacco and nicotine products. If you have any questions, please consult with your recruiter.

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

Scheduled Weekly Hours

40

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