Manager, Care Management-Medicaid/Maternity

Become a part of our caring community and help us put health first
 The Manager, Care Management leads our HumanaBeginnings maternity team focusing on assisting members achieve optimal health outcomes and reduce high risk pregnancies. The Manager, Care Management works within state contractual guidelines; applies advanced clinical knowledge to solve moderately complex care gaps; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

Responsibilities of the role include:

• Oversees the assessment and evaluation of pre and post-partum Medicaid enrollees' needs and requirements to achieve and/or maintain optimal wellness.
• Oversight and management of a team of Care Managers operating within our HumanaBeginnings maternity model approach utilizing resources, evidence-based practice to supports the needs of members through an interdisciplinary-multidisciplinary care team.
• Makes decisions that are typically related to high-risk maternity, resources, approach, and tactical operations for projects and initiatives involving maternity departmental area.
• Requires cross departmental collaboration and conducts briefings and area meetings; maintains maternity related state and compliance reporting; and works in contact with other managers across the department.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree in Nursing
• 5 or more years of nursing experience
• Active Registered Nurse (RN) license in good standing
• Must reside within a 2-hour radius of Louisville, KY
• Proficiency in analyzing and interpreting data trends.
• Progressive business consulting and/or operational leadership experience
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint

Preferred Qualifications

• 2 or more years of management experience
• Maternity related experience
• Case Management experience, managing member's health outcomes
• Previous experience working in a managed care field
• Bilingual

Additional Information

• Workstyle: Hybrid Home - Quarterly travel to the Louisville, KY office
• Typical Work Days/Hours: Monday through Friday, 8:00 am – 5:00 pm EST.

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 leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Benefits

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

HireView

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.

SSN 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.

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.

 

$86,300 - $118,700 per year

 

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

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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