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Humana Health Horizons in Ohio is seeking Field Care Managers, Behavioral Health 2 who will assess and evaluate 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 BH CM must perform the full scope of care coordination activities and responsibilities for members who need care coordination and are not assigned to a Care Coordination Entity, the OhioRISE Plan, and/or a Care Management Entity, or who choose to receive their care management from the MCO. The BH CM would serve as the single point of contact for care coordination.  

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The BH CM Plus must ensure the completion of the full scope of care coordination activities and responsibilities for members who need care coordination and are assigned to a Care Coordination Entity, the OhioRISE Plan, CPCs, and/or a Care Management Entity. Care Manager Plus serves as the single point of contact for care coordination.

•  Ensuring the member receives the full scope of care coordination services, including comprehensive assessment completion (inclusive of the HRA), person-centered care plan completion, ensuring no duplication with the CCEs (Ohio RISE Plan, and/or CME), and identifying and addressing ongoing needs.
• Providing actionable data, information, and support to assist the CCE, OhioRISE Plan, and/or CME in meeting the member's care needs.
•  Integrating information collected by the external Care Coordination Entities into the Care Coordination Portal to minimize duplication of efforts.

 

Position Responsibilities:

The Field Care Manager, Behavioral Health 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care.

• Performs telephonic and 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.  
•   Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations.
• Creates member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Collaborates with providers and community services to promote quality and cost-effective outcomes. 
• Ensures the delivery of needed services/supports for Behavioral Health, Physical Health, Social Determinant of Health and value added benefits.
• Coordinates across the transdisciplinary care team and with the PCP and supports transitions of care.
• Submits incident reports.

Use your skills to make an impact
 

 Required Qualifications

• Must reside in Ohio in Cuyahoga County.
• Applicable state licensure in field of study with no disciplinary action: Licensed Masters Clinical Social Worker (LCSW), Clinical Social Worker (CSW), Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), or Registered Nurse (RN).
• Minimum of 2 years of post-degree clinical experience in a behavioral health setting.
• Case management experience.
• Must have a Child and Adolescent Needs & Strengths (CANS) certification or able to obtain one within 60 days of hire.
• 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.
• This role is a 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.

 

Preferred Qualifications:

• Case Management Certification (CCM).
• Experience working with Medicare, Medicaid and dual-eligible populations.
• Fiel