The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.
The Manager, Care Management oversees the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
This role requires travel within Miami Dade County, FL.
The Manager, Care Management shall meet one of the following qualifications:
Master's Degree in human services, social sciences, or health related field with at least 2 years of case management experience with at least 1 year focused on elderly or disabled population.
Bachelor's Degree in a health related field with at least 5 years of case management experience with at least 1 year focused on the elderly or disabled population.
9 years of professional human service experience with a minimum of 5 years of case management experience with at least 1 year focused on the elderly or disabled population.
The Manager, Care Management shall meet all of the following qualifications:
Must be able to speak, read and write in both languages without limitations or assistance.
If an LPN or RN must have an active RN or LPN license in the state of Florida without restrictions .
This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.
Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work.
Must have accessibility to high speed DSL or Cable modem for a home office (No Satellite).
Intermediate to advanced computer skills and experience with Microsoft Word, Excel and Outlook.
This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
AHCA Fingerprint Required.
Previous leadership experience.
BSN or Bachelor's degree in a related field.
Health Plan experience.
Previous Medicare/Medicaid experience.
Call center or triage experience.
Previous experience in utilization management, discharge planning and/or home health or rehab.
Prior nursing home diversion or long term care case management experience.
Experience with health promotion, coaching and wellness.
Experience working with the geriatric population.
As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, 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