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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).

• You will 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.
• You will guide the development, implementation, and evaluation of care management programs to align organizational objectives and regulatory requirements.
• You will lead multiple managers or highly specialized professional associates.
• You will monitor data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities.
• You will facilitate effective communication and collaboration with internal and external stakeholders, including providers, payers, and regulatory agencies.
• You will lead the preparation and presentation of program reports, utilizing data analytics to monitor performance, identify trends, and recommend improvements.
• You will 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.
• 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.

Preferred Qualifications

• Advanced degree in nursing, Social Work or business-related field
• Experience with MLTSS and HealthChoice Populations.
• 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.

Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

 

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

 

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$104,000 - $143,000 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual per