Become a part of our caring community
 

At Humana, caring is everything. You look after our members and patients. We look after you. If caring means something to you too, we've got a spot for you. We design competitive and flexible benefits packages to provide our employees a sense of financial security now and in the future.
Fostering a culture of inclusion is part of the fabric of who we are. We must have a workplace that reflects the people we serve and thrives in part because every person can bring their whole self to work to make an impact. Our vibrant, diverse culture and environment of inclusion is one of our greatest strengths.
About Humana Healthy Horizons
Humana Healthy Horizons is more than a health plan. We're human care. Humana Healthy Horizons focuses on helping people achieve their best health. Our dedicated strategies across multiple markets and states ensure partnerships with state and local governments, community-based organizations, and national partners that commit to removing barriers to helping people achieve their best health.
The individual in this role will work as an Oklahoma-based, primarily telephonic care manager. This care manager will assess and evaluate enrollees' needs and requirements to achieve or maintain optimal wellness. The care manager will guide enrollees/families towards and facilitate interaction with appropriate resources for their care and wellbeing. You 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 Behavioral Health Nurse 2 work assignments are varied but will focus on those enrollees with behavioral health needs. The Care Manager, Behavioral Telephonic Nurse 2 will use clinical expertise and experience to determine when they require face-to-face enrollee support. You will engage the appropriate members of the care management team and/or coordinate the care manager to meet the enrollee in person. We design this team-based approach 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.

Position Responsibilities:

• Performs telephonic and face to face assessments and evaluations of the member's needs and requirements. These assessments aim to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources. This guidance enables 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.
• Identify and resolve barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
• Follow established guidelines/procedures.
• Collaborate with providers and community services to promote quality and cost-effective outcomes.

Use your skills to make an impact
 

Required Qualifications:

• Must Reside in Oklahoma
• Active Registered Nurse (RN) license, or a LCSW, LPC, LMFT
• Minimum 1-year Behavioral Health clinical experience
• 2 or more years of experience of in-home case or care management
• Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits.
• Knowledge of community health and social service agencies and additional community resources
• Comprehensive knowledge of all Microsoft Office applications
• Periodic travel to Humana Oklahoma City office for meetings and training

Preferred Qualifications:

• Case Management Certification (CCM)

Additional Information

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 leadershi