Become a part of our caring community
 

Oversee the assessment and evaluation of member's physical and behavioral health needs to achieve and maintain wellness by guiding members and their families/caregivers toward appropriate for the member's care and wellbeing.
Guide the development, implementation, and evaluation of care management programs to align organizational goals and regulatory requirements.
Lead multiple managers and highly specialized processional associates
Monitor data sharing among internal and external resources to ensure service integration, continuity of care, and contractual compliance, addressing challenges, risk, and opportunities.
Facilitate communication and collaboration with internal and external stakeholders, including providers, payers, vendors, and regulatory agencies.
Lead the preparation and presentation of program reports, using data analytics to monitor performance, identify trends, and recommend improvements.
Champion initiatives for process improvement and innovation to advance care management practices and outcomes.

• You will oversee the assessment and evaluation of member's physical and behavioral health needs to achieve and maintain optimal wellness by guiding members and their families/caregivers toward appropriate for the member's care and wellbeing.
• You will guide the development, implementation, and evaluation of care management programs to align organizational objectives and regulatory requirements.
• You will lead multiple managers and highly specialized processional associates
• You will monitor data sharing among internal and external resources to ensure service integration, continuity of care, and contractual compliance, addressing challenges, risk, and opportunities.
• You will facilitate effective communication and collaboration with internal and external stakeholders, including providers, payers, vendors, 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:

• Bachelor's Degree
• Active Registered Nurse (RN) license or Social Work (SW) license
• Must be willing to travel into IL as needed for meetings, audits, or other departmental needs.
• 6 or more years of professional experience
• 2 or more years of previous formal leadership/management experience
• Proficiency in analyzing and interpreting data trends
• Progressive business consulting and/or operational leadership experience

Preferred Qualifications:

• Advanced degree in nursing, health science, or business-related field
• Previous experience working in a managed care field
• 5 or more years of previous management/supervisor level experience

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.

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.

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 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
 

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.

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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.