Medicaid Field Care Manager, Behavioral Health

Become a part of our caring community and help us put health first

The Field Care Manager, Behavioral Health 2 assesses and evaluates member's 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. The Field Care Manager, Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Care Management is an overall approach to managing enrollees' care needs and encompasses a set of activities intended to improve patient care and reduce the need for medical services by enhancing coordination of care, eliminating duplication, and helping patients and caregivers more effectively manage health conditions.

The Behavioral Health Care Manager will perform telephonic or face to face assessments and evaluations of the member's needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member. The Behavioral Health Care Manager will coordinate and collaborate with providers and community services to promote quality and cost-effective outcomes.

In this role, the Behavioral Health Care Manager provides comprehensive support to members who have recently been discharged from inpatient facilities, as well as those with a history of frequent readmissions. The position requires effective collaboration across internal teams and with both inpatient and outpatient providers to promote continuity of care and achieve positive health outcomes for members.

The Behavioral Health Care Manager employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental and psycho-social health issues by advocating, empowering and assisting the member in transforming their current state. The Behavioral Health Care Manager identifies and resolves barriers and social determinants that hinder effective care and health outcomes. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.

The Role may include creating member's plan of care as well as influencing department strategy, decision making on cases and approaches for project components. The Behavioral Health Care Manager will exercise considerable latitude in determining objectives and approaches to assignments. Knowledge of community health and social service agencies and additional community resources

• An active, unrestricted KY Licensed Masters Clinical Social Worker (LCSW),
  OR
• KY Licensed Professional Clinical Counselor (LPCC) OR
• KY Licensed Marriage Family Therapist (LMFT)
  OR
• Other independent professional KY state license with 1+ year of post-degree clinical experience in behavioral health OR
• Active, unrestricted Kentucky Registered Nurse (RN) license with at least three years of experience in behavioral health.

• Intermediate or advance proficiency using Microsoft Office Word, Excel, PowerPoint, navigating multiple systems and platforms and ability to troubleshoot and resolve basic technical difficulties in a remote environment.
• Must reside in the state of Kentucky or a county that is contiguous to Kentucky state border in Ohio, Indiana, Tennessee or Virginia.

• Experience working with the KY Medicaid Population.
• Managed Care Experience.
• Case Management Certification (CCM).
• Experience working with Severe and Persistent Mental Illness (SPMI) and/or Substance Abuse Disorder (SUD) patients.
• Experience with behavioral change, health promotion, coaching and wellness.
• Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish.

• Workstyle & Travel: This is a remote position that requires you to travel up to 10% up to 50 miles from where you reside. Employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Travel also includes attending face to face and collaborative meetings at Humana's Louisville, KY location.
• Schedule: Must be available to work an 8-hour shift Monday through Friday between hours of 8:00 - 6:00 PM (EST). Leadership will discuss scheduling in interview.
• Driver's License, Reliable Transportation, Insurance. This role is part of Humana's Driver safety program and therefore requires an individual to have: A valid state driver's license, proof of personal vehicle liability insurance with at least 100/300/100 limits, and a reliable vehicle.
• Language Assessment: Any Humana employee who speaks with a member in a language other than English must take a language…