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

The Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) 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 (Care Manager, Behavioral Health) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Additional responsibilities for the BH CM are further defined by these two separate roles:

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 (i.e. the OhioRISE Plan, and/or a CME, or who choose to receive their care management from the MCO) and serves as the single point of contact for care coordination.  Or

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 (i.e. the OhioRISE Plan, CPCs, and/or a CMEs). 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 CCE into its Care Coordination Portal to minimize duplication

Position Responsibilities:

The Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) 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 (at a minimum the PCP) and transitions of care
• Submits incident reports

Use your skills to make an impact
 

 Required Qualifications

• 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 behavioral health setting
• Case management experience
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Additional Requirements/Adherence

Workstyle: Combination remote work at home and onsite member facing

Location: Must reside in Ohio

• Prefer Northeast Ohio

Hours: 40 hour work week Monday through Friday 8:00 AM 5:00 PM Eastern, over-time may be requested as business needs.

Travel: Must be willing to commute about 50% to meet with members. More information will be provided during the interview.

Remote Work at Home Requirements

• Must have a separate room with a locked door that can be used as a home office to ensure absolute and continuous privacy during while you work
• Must have accessibility to hardwired high speed internet with minimum speeds of 25Mx10M for a home office (Wireless and Satellite are prohibited)

Tuberculosis (TB) screening

• This role is considered member 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.

Driver's License, Transportation, Insuran