[Applicants: Over 200 applicants | Industry: Insurance | Type: Full-time | Level: Mid-Senior level]
Become a part of our caring community and help us put health firstHumana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health professionals responsible for care management. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.The Manager, Care Management supervises, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordination activities.Leads cross-functional collaboration through regular briefings and area meetings; maintains ongoing communication with departmental managers to ensure alignment and operational efficiency.Identify members for specific case management and / or disease management activities.Monitors case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions.Develop system-view recommendations, reports trends and implement appropriate actions to control trends.Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met.Develop reporting tools in collaboration with leadership to identify clinical performance.Interviews, hires, mentors, evaluates, coaches and manage performance for a diverse care coordination team.Onboards new associates including but not limited all pre-employment human resource tasks, ordering software, hardware, supplies and support technologies.Monitors performance of staff including service performance and adherence to established utilization and care coordination benchmarks.Required QualificationsUse your skills to make an impactApplicants must reside in the central Chicago, IL area or within reasonable commuting distance.An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois.Five (5) or more years of professional experience working in the health care industry and/or in care management.Two (2) or more years o...
