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

The Field Care Manager, Behavioral Health 2 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 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

This role requires 50-75%, about 3 days weekly travel to meet with Medicaid members in hospitals and acute settings.

The hours of this role are Mon-Fri, 8:30am - 5pm EST. No rotating weekend or holidays. Over-time as business needs.

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. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Additional Duties:

This SW will primarily support the Utilization Management Team. SW will work closely with internal, nurse liaison to assist in discharge planning needs of members in acute and post-acute settings. SW will facilitate case conferences, as needed, with UM team, medical directors, members and providers. SW will assist in screening and planning for SDOH barriers to discharge plan. SW will meet with UM nurses weekly to discuss cases with length of stay 14 days or longer, complex cases and ad hoc cases that have identified social needs. SW will meet with members bedside in acute and post-acute settings to screen members and assist with SDOH resources. SW will assist members with initiating process for Medicaid Institutionalized care Program (ICP) and Home and Community based Services (HCBS) waiver application for Long Term Care. This role supports case management/utilization manager related to reducing Inpatient admits, readmits and ER visits.

Use your skills to make an impact
 

Required Qualifications​:

• Master's degree in SW or master's in social services related field

• Minimum 3 years clinical experience working in the hospital setting with case management and discharge planning

• Experience working with Medicaid Population

• Experience is addressing social determinants of health and closing social gaps in care

• Familiarity with additional treatment settings from hospital to include: Skilled nursing facility, Intermediate rehab facility and Long term acute-care hospital

• Intermediate to Advanced using MS Office Word, Excel, Outlook

• Excellent computer skills and ability to easily navigate multiple applications

Preferred Qualifications

• Bilingual in English/Spanish

• Managed care experience (Medicaid)

• LSW, LCSW

Additional Requirements / Adherence

Workstyle: Field

Locations: Hillsborough, Highland, Polk, Manatee, Hardee, Seminole, Orange, Brevard, Osceola

Schedule:

• 8:30 AM - 5:00 PM Eastern Time, Monday through Friday

• No weekend or holiday coverage

• Over-time as business needs

Travel: 50-75%, about 3 days weekly travel to meet with Medicaid members in hospitals and acute settings.

Additional Information

Social Security Alert

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Modern Hire Interview

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

To ensure Home or Hybrid Home/Office employees’ ability to work effectiv