Experience Inc. Jobs

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

Humana Healthy Horizons in Virginia is seeking an Associate Director, Care Management (LTSS/ABD) who will lead teams of healthcare professionals responsible for care management. They will lead and guide others in providing integrated services for the clinical teams. The Associate Director, Care Management requires a solid understanding of how organization capabilities interrelate across department(s).

• Manages day-day operation for Long-Term Services and Supports and Aged, Blind or Disabled (LTSS/ABD) clinical care management team.

• Provides ongoing associate coaching and feedback to enhance associate contribution, competency, and performance.

• Oversees 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.

• Participates in Care Management collaborative meetings as required by the Virginia Department of Medical Assistance (DMAS)

• Makes decisions related to identifying and resolving complex technical and operational problems within department(s) and leads multiple managers or highly specialized professional associates.

• Monitors data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities.

• Leads a team that delivers care management services to our members with an agile approach in partnership with technology, provider relations, and other key stakeholders while managing operational risks and contractual/regulatory risks.

• Develops and achieves performance metrics for a fast-paced comprehensive case management environment.

• Assures contractual compliance with mandated and corporate policies regarding other departmental areas such as medical management, utilization management, population health and quality.

• May require cross functional departmental/market collaborations and conducts briefings and area meeting; maintain frequent communication with team members.

• Attracts, develops, empowers, and inspires talent to help Humana Healthy Horizons deliver on their contractual and business strategy.

• Develops educational and training programs for the LTSS/ABD care management team.

• Collaborates with other Humana leadership to identify the clinical tools and systems to support LTSS Care Management activities.

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) .

• An active, unrestricted, Registered Nurse (RN) license or Licensed Mental Health Professional (LMHP) in the Commonwealth of Virginia.

• Five (5) years of professional experience working with complex populations or in manage care settings.

• Three (3) years of management or supervisory experience.

• 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.

• 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

• Advanced degree in nursing or business-related field.

• Five (5) or more years of professional experience in Care Management, specifically in the delivery of care for elderly or special needs high risk populations such as the Aged, Blind and Disabled (ABD) and those enrolled in Long-Term Services and Supports (LTSS) Waiver Services, in hospice, individuals with developmental disabilities, or have skilled needs and/or in nursing facilities.

• Five (5) or more years of previous management/supervisor level experience.

• Previous experience leading managed care field/remote staff.

• Case Management Certification (CCM).

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 5.

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 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.

Interview Format

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.

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.$102,200 - $140,700 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, 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 because he or she is a protected veteran. 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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.