Become a part of our caring community
 

The Care Manager, Telephonic Behavioral Health, assesses and evaluates members' needs in a telephonic environment. The goal is to achieve and maintain wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

You will report to the Manager of Health Services.  Additionally, you will be in a field role and will require up to 25% travel visiting members or facilities within the state of South Carolina.

The Care Manager, Telephonic Behavioral Health 2 employs a variety of strategies and techniques to manage a member's physical, environmental and psycho-social health issues. Resolve barriers that hinder care. Ensure patient is progressing towards desired outcomes by monitoring patient care through assessments and evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Support the Transition of Care (TOC) program, which focuses on ensuring continuity of care for members as they move between care settings (such as hospital discharge to home or outpatient care). You will be assisting with HEDIS completion follow up visits after TOC and may conduct field visits based on member needs and program requirements.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's degree

• Must live in the state of South Carolina

• Must have an active license in South Carolina as either a Licensed Professional Counselor (LPC) OR Licensed Independent Social Worker - Clinical Practice (LISW - CP)

• 3 or more years of experience working as a licensed Social Worker

Preferred Qualifications

• Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university

• 1 year of managed care experience

• Transition of care (TOC) experience

• CCM certification

• Experience working with the geriatric population

• Knowledge of community health and social service agencies and additional community resources

Additional Information

Workstyle: Remote Work at Home with Field requirements

Field - This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.

Location: South Carolina

Work Schedule: Monday - Friday; 8:00 AM - 5:00 PM Eastern Time

Travel: 25%

Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• 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

TB

This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Driving Statement:

This role is part of our company's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Medicaid Mileage Reimbursement

We provide mileage reimbursement for work-related travel. Eligible mileage includes:

• Travel from your home to your first work location of the day.

• Travel between client or assignment locations during the workday.

• Travel from your final