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

The individual in this role will work as an Oklahoma-based, primarily telephonic care manager, assessing and evaluating enrollees’ needs and requirements to achieve or maintain optimal wellness by guiding enrollees/families towards and facilitating interaction with appropriate resources for their care and wellbeing. The individual in this role will work in collaboration with the interdisciplinary care management team. This team includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. The Care Manager, Telephonic Physical Health work assignments are varied but will focus on those enrollees with primarily physical health needs. The Care Manager, Telephonic Physical Health will utilize clinical expertise and experience to determine when face-to-face enrollee support is required, engaging the appropriate members of the care management team and/or coordinating in-person meetings between the care manager and the enrollee. This team-based approach is designed to ensure enrollees receive holistic person-centered care. Work assignments for this role are varied and frequently require interpretation and independent determination of the appropriate courses of action.

• 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.
• Employs a variety of strategies, approaches, and techniques to manage an Enrollee’s behavioral, physical, environmental, and psycho-social health needs.
• Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations.
• Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
• Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed.
• Follows established guidelines/procedures. 
• Collaborates with providers and community services to promote quality and cost-effective outcomes. 
• Periodic travel to Humana Oklahoma City office for meetings and training.

Use your skills to make an impact
 

Required Qualifications

• Must Reside in Oklahoma
• Candidates must have one of the following:
• Active Registered Nurse (RN) license (without restrictions)
• Licensed Clinical Social Worker (LCSW)
• Licensed Professional Counselor (LPC)
• Licensed Professional Clinical Counselor (LPCC)
• Licensed Marriage and Family Therapist (LMFT)
• Licensed Professional Art Therapist (LPAT)

• Minimum 1-year clinical experience
• 2 or more years of experience of in-home case or care management
• Exceptional communication and interpersonal skills with the ability to quickly build rapport.
• Knowledge of community health and social service agencies and additional community resources.
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
• Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
• This role is 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 100/300/100 limits.
• This role is considered member facing and is part of Humana Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.   

Preferred Qualifications:

• Proficiency in Spanish and English (Bilingual)
• Case Management Certification (CCM)

Work at Home Criteria 

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provid