Job Description
Become a part of our caring community
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
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Workstyle: This is a remote position.
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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.
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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
40Pay 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 yearThis 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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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