Remote South Carolina · Remote
Full-time
Mid level
2 weeks ago
Verified apply link — checked 6 hours ago
Salary undisclosed
Become a part of our caring community Humana Healthy Horizons is more than a health plan—we deliver human care. We help people achieve their best health by partnering with state and local governments, community-based organizations, and national partners to remove barriers to care and well-being. In this South Carolina–based role, the Behavioral Health Case Manager assesses enrollees’ needs and helps individuals and families access the clinical, community, and social resources needed to achieve or maintain optimal wellness. This position primarily supports enrollees with complex and intensive health needs and coordinates person-centered care across telephonic and in-person settings. You will report to Manager, Care Management Behavioral Health. Conduct telephonic and face-to-face assessments to evaluate each enrollee’s behavioral, physical, environmental, and psychosocial needs, and use a variety of care management strategies to support optimal health and well-being. Develop individualized, person-centered care plans; guide enrollees and families to appropriate clinical, community, and social resources; and collaborate with providers and community-based services to promote high-quality, cost-effective outcomes. Identify and resolve barriers to effective care, monitor progress through ongoing assessments and evaluations, and adjust interventions needed to help enrollees achieve desired outcomes. Collaborate with the interdisciplinary care management team, including community health workers, housing support specialists, and care management support assistants, to coordinate holistic support. Apply clinical expertise and professional judgment to determine when face-to-face support is appropriate, engage relevant care team members, and coordinate in-person meetings with enrollees when indicated. Interpret varied and complex information, independently determine appropriate courses of action, follow established guidelines and procedures, and align daily responsibilities with departmental, segment, and organizational strategies and operating objectives. How You Will Make an Impact You will use a collaborative, team-based approach to help ensure enrollees receive coordinated, holistic care that reflects their goals, preferences, and overall well-being. Use your skills to make an impact Required Qualifications Must Reside in South Carolin a Active Registered Nurse (RN) license, or a Licensed Master Level Social Worker license (LCSW, LMSW, LPC, LMFT or similar) . Minimum 1-year Behavioral Health clinical experience 2 or more years of recent experience of case or care management Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits. Knowledge of community health and social service agencies and additional community resources Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint Periodic travel to Humana Columbia office for meetings and training Preferred Qualifications Experience working in Community Mental Health or as part of a crisis response team or Assertive Community Treatment (ACT) team, and substance use disorder treatment Experience working with both children and adults Workstyle: This is a remote, field-based position serving members throughout an assigned South Carolina service area. The role requires a dedicated workspace that protects member privacy and complies with PHI and HIPAA requirements. Travel: This role requires at least 50% local travel for face-to-face meetings and field-based interactions with enrollees, their families, providers, and staff. Workdays and Hours: Monday–Friday, 8:00 a.m.–5:00 p.m. 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 conn
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