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

Humana Healthy Horizons in Virginia is seeking a Manager, Service Coordination (Manager, Care Coaching) who will lead teams of Service Coordinators (Care Coaches) responsible for the oversight of evaluation of member's needs and requirements to achieve and/or maintain optimal wellness state. The Manager, Service Coordination (Manager, Care Coaching) works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals.

• Oversees the service coordination staff and monitors assessments and evaluation of members' needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families towards and facilitates interaction with resources appropriate for the care and wellbeing of members.
• Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area and requires cross departmental collaboration.
• Conducts briefings, and area meetings, maintains frequent contact with other managers across the department.
• May participate in Interdisciplinary team meetings.
• Develops service coordination policies and procedures to ensure compliance with state and federal requirements and incorporate industry best practices.
• Supports leadership in meeting goals of the department/market.

Use your skills to make an impact
 

Required Qualifications

• Must reside in the Commonwealth of Virginia or within a 40-mile radius from Virginia in a bordering state/district (Washington DC, MD, WV, KY, TN & NC).
• Bachelor's degree in human services, social sciences, or a health-related field.
• Three (3) or more years of professional experience working with complex populations or in manage care settings.
• Two (2) or more years of management or supervisory experience.
• 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.
• Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport.
• 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.
• Must be able to travel throughout the Commonwealth of Virginia.
• This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

Preferred Qualifications

• Master's degree in human services, social sciences, or health-related field.
• Care Management certification (CCM). 
• Active, unrestricted, Registered Nurse (RN) license or Licensed Mental Health Professional (LMHP) in the Commonwealth of Virginia.
• Three (3) or more years of managed care experience in Medicare and/or Medicaid, specifically in the delivery of care for elderly or special needs populations such as the Aged, Blind and Disabled (ABD) and those enrolled in Long-Term Services and Supports (LTSS) Waiver Services, in hospice and/or in nursing facilities.
• Proficiency in analyzing and interpreting financial trends.
• Previous experience in utilization management, discharge planning and/or home health or rehabilitation.
• Experience with initiating services plan for members.
• Experience with health promotion, coaching and wellness.
• Health Plan experience.

Additional Information

• Workstyle: This is a Remote position that will require you to travel.
• Travel: Up to 25% of the time to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as field interactions with providers, members, and their families.
• Typical Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
• Direct Reports: Up to 15.

Work at Home 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 recommended; 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