Director, Care Management

Director, Care Management - SC Join to apply for the Director, Care Management - SC role at Humana. This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $126,300.00/yr - $173,700.00/yr Overview The Director, Care Management Service Coordination leads teams of nurses and behavior health professionals responsible for care management. The Director, Care Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment. Humana Healthy Horizons in Indiana is seeking a Service Coordination Administrator (Director, Care Management) who will provide oversight of the market’s service coordination team and ensure member health outcomes and contractual performance objectives are met. They will ensure the program and resources are used effectively and successfully to execute short- and long-term goals. The Service Coordination Administrator is dedicated to the Indiana PathWays program. Key Responsibilities Partner with the Care Coordination Leader and other key staff to ensure successful management and excellence in care and service coordination for our members Leads and Partners with external organizations providing service coordination to our members Leads, develops, and operationalizes LTSS service coordination within Humana's population health strategy, education, and quality improvement activities for the clinical team. Develops, implements, measures, analyzes, and reports on programs and initiatives designed to improve the health and quality of life of our members. Provides input into functions strategy. Leads, mentors, exemplifies, and inspires teams responsible for service and transition coordination. 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. Makes decisions typically related to the implementation of new/updated programs or large‑scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Encourages professional responsibility and assist with professional development. Defines key staff productivity and quality indicators that meet industry standards. Provides input to education and training programs for service and transition coordination teams Collaborates with other Humana leadership to identify the clinical tools and systems to support care management activities. Required Qualifications Must reside in the state of Indiana. Must meet one of the following: Indiana licensed registered nurse (RN) in good standing with a minimum of three (3) years of management experience Master’s level degree with a minimum of three (3) years of management experience Bachelor’s level degree in social work, psychology, sociology, counseling, gerontology, or health and human services with a minimum of two (2) years’ full‑time direct service experience with the elderly or disabled and a minimum of three (3) years of management experience Experience with long term services and supports (LTSS) and home and community‑based service coordination as it relates to implementing practices to improve social determinants of health Knowledge about Indiana community resources, and prior experience with the program population and informal caregivers Proven success in team‑building and training/coaching staff to meet operational requirements and goals. Comprehensive knowledge of all Microsoft Office applications, specifically Outlook, Excel, and PowerPoint. Proficiency in analyzing and interpreting clinical and utilization trends. Understanding of health plan and regulatory rules, managed care, care management, disease management and referral processes. Ability to analyze and integrate information and make sound decisions based upon established guidelines. Commitment to the creation of a collaborative and supportive work environment. Must be able to come into the downtown Indianapolis, IN office three days per week. Preferred Qualifications Licensed RN in the state of Indiana without restrictions. Care Management certification (CCM). Work‑At‑Home Requirements At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi‑weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver’s License, Transportation, Insurance Valid state driver's license Proof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limits Access to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format We will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision‑making ability. You will be able to respond to the recruiter’s preferred method via text, video, or voice technologies. If selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required. Scheduled Weekly Hours 40 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 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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, rate of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Seniority level Director Employment type Full‑time Job function Health Care Provider Industries Insurance Referral Information Referrals increase your chances of interviewing at Humana by 2x. #J-18808-Ljbffr