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

Humana Gold Plus Integrated is seeking Associate Directors of Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding of how organizational capabilities interrelate across department(s). The Associate Director, Care Management, makes decisions related to resolving complex technical and operational problems within department(s).

• Oversee the assessment and evaluation of members' needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
• Guides the development, implementation, and evaluation of care management programs to align organizational objectives and regulatory requirements.
• Leads multiple managers or highly specialized professional associates.
• Monitors data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities.
• Facilitate effective communication and collaboration with internal and external stakeholders, including providers, payers, and regulatory agencies.
• Lead the preparation and presentation of program reports, utilizing data analytics to monitor performance, identify trends, and recommend improvements.
• Champion initiatives for process improvement and innovation to advance care management practices and outcomes.

Use your skills to make an impact
 

Required Qualifications

• Must reside in the state of Illinois, Indiana or Wisconsin.
• An active, unrestricted, Registered Nurse (RN) license, Licensed Clinical Social Worker (LCSW) OR Licensed Clinical Professional Counselor (LCPC) in the state of Illinois.
• Six (6) or more years of professional experience working in the health care or managed care industry.
• Three (3) or more years’ experience working for a managed care health plan.
• Minimum of two (2) years of experience in a leadership role managing other leaders or supervisors.
• Three (3) or more years of experience leading care coordination teams to drive measurable outcomes across diverse member populations.
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
• Proficiency in analyzing and interpreting data trends.
• Progressive business consulting and/or operational leadership experience.
• Must be able to travel in the state of Illinois to provider offices, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare & Medicaid Services (CMS) and Humana's Illinois locations.
• 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.

Preferred Qualifications

• Residency in the state of Illinois.
• Advanced degree in nursing, Social Work or business-related field
• Previous experience working in a managed care field
• Five (5) or more years of previous management/supervisory level experience.

Additional Information

• Workstyle: This is a remote position.  
• Travel: Up to 25% to provider offices, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare & Medicaid Services (CMS) and Humana's Illinois locations for team engagement meetings.
• Direct Reports: Up to 8.

WAH Internet Statement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees 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 employees 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.

Interview Format

As part of our hiring process fo