Manager, Care Management – RN or SW
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Humana care management leader overseeing nurse and social-work teams serving Michigan healthcare members. Managing clinical performance, staff development, compliance, and field-based member care.
Responsibilities:
- Lead teams of nurses and behavioral health professionals responsible for care management
- Oversee assessment and evaluation of members' needs to achieve or maintain optimal wellness
- Guide members and families toward appropriate care and wellbeing resources
- Collaborate across departments and conduct briefings and area meetings
- Maintain frequent contact with other department managers
- Oversee delivery of care to all members served by the location
- Review member case information and determine assessment needs and required disciplines
- Monitor staff performance, service performance, and adherence to care coordination benchmarks
- Identify members for case management and disease management activities
- Develop audit plans and tools to ensure compliance with state contract performance metrics and member needs
- Develop reporting tools with leadership to identify clinical performance
- Interview, hire, coach, evaluate, and mentor a diverse care coordination workforce
- Onboard new staff, including pre-employment HR tasks and ordering software, hardware, supplies, and support technologies
- Monitor case management activities, post-discharge calls, discharge planning, and pre-assessment of elective admissions
- Travel within Wayne and Macomb Counties for field-based interactions, up to 50%
Requirements:
- Must reside in Michigan and be able to travel to Wayne County or Macomb County
- Active Registered Nurse (RN) license or Social Work (SW) license in the state of Michigan
- 3+ years of professional experience as a licensed RN or Social Worker, including experience in case and/or disease management
- 1+ year of leadership and people management experience in a home care, hospice, or similar field-based healthcare setting
- Demonstrated experience coaching, supporting, and developing clinicians in a fast-paced healthcare environment
- Proficiency in analyzing and interpreting data trends
- Comprehensive knowledge of Microsoft Office applications, including Word, Excel, and PowerPoint
- Associate's Degree preferred
- Certified Case Manager (CCM) preferred
- 3+ years of previous management/supervisor-level experience preferred
- Experience with Medicaid Long Term Care preferred
- Fully bilingual in English and Spanish or Arabic preferred
- Ability to take the Interagency Language Rating (ILR) test if speaking with members in a language other than English
- Must complete TB screening if selected
- Valid state driver's license required
- Must maintain personal vehicle liability insurance meeting stated minimum requirements
- Must meet home internet and dedicated workspace requirements
Benefits:
- Bonus incentive plan based on company and/or individual performance
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company and personal holidays
- Paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
- Personal wellness and smart healthcare decision support
- Eligible mileage reimbursement for travel between home and work locations, client or assignment locations, and final work location to home
- Home office work arrangement
- Occasional travel to Humana offices for training or meetings
- Self-provided internet service meeting minimum speeds of 25 Mbps download and 10 Mbps upload
- Dedicated work space to protect member PHI / HIPAA information
Similar Jobs
Senior Manager
P&C insurance SME shaping EXL's AI agentic solutions and go-to-market strategy. Translating insurance expertise into prototypes, collateral, and account-manager enablement.
Senior Manager, Supply Planning
Senior Manager planning clinical supplies for Iovance’s TIL cancer therapies. Managing forecasts, packaging, distribution, and trial supply strategy.
Junior Customer Manager
Junior Customer Manager supporting housing and real-estate clients for PROMOS consult. Coordinating inquiries, proposals, and contract solutions across customer-facing teams.
Senior Manager, DC Safety
Senior Manager leading safety strategy, compliance, and risk reduction across Alo’s distribution center network. Coaching safety leaders and supporting onsite operations during growth and change.
Business Line Manager – Mobile Crushers and Screens
Business Line Manager leading Sandvik’s North American mobile crushing and screening sales. Driving equipment, aftermarket, distributor and customer growth across the U.S. and Canada.
Contract Negotiation Manager
CVS Health contract manager negotiating provider agreements, resolving disputes, and managing provider network performance. Supporting healthcare network quality, accessibility, compliance, and financial goals.
Service Area Manager
Service Area Manager leading heavy-duty truck service branches for FleetPride, the U.S.’s largest aftermarket distributor of truck and trailer parts. Driving operational performance, staffing, training, and regional growth.
Post-Merger Integration Manager
Post-merger integration manager leading acquisition integrations for Yopeso, a software product company. Coordinating global teams, workstreams, risks, and organizational change from pre-close through stabilization.
Senior Proposals Manager
Senior Proposals Manager leading clinical trial budgets, bids, and pricing strategies for Quanticate, a global data-focused CRO. Improving proposal processes and supporting pharmaceutical and biotech clients.
Contracts Manager
Contracts Manager leading strategic, high-complexity defense and intelligence contracts for SAIC. Managing negotiations, compliance, risks, and a contracts team supporting Air Force programs.
Franchise District Manager
Franchise district manager overseeing TA Petro’s franchise travel centers across the Eastern USA. Supporting site profitability, compliance, customer experience and franchise growth.
Strategic Accounts Manager
Strategic Accounts Manager leading national insurance agency partnerships, P&L, and multi-year growth. Driving digital integration, profitability, retention, and executive relationships for Mercury Insurance.
Site Manager
Site Manager leading field operations, safety, schedules, subcontractors, and closeout for Gray Construction’s large industrial projects. Travel required to project sites across the United States.
IFRS Manager
IFRS Manager owning consolidated reporting and complex IFRS methodology for Kiss My Apps’ global B2C platform businesses. Coordinating audits and improving financial reporting processes.
Field Reimbursement Manager – Neuroscience
Field Reimbursement Manager educating healthcare providers and resolving reimbursement barriers for Johnson & Johnson Neuroscience therapies. Managing access across the Raleigh territory and surrounding accounts.
Field Reimbursement Manager – Neuroscience
Field Reimbursement Manager educating California healthcare providers on reimbursement and patient access. Supporting J&J Neuroscience therapies across San Francisco, San Jose, Fresno, and Sacramento territories.
Field Reimbursement Manager – Neuroscience
Field Reimbursement Manager educating providers and resolving reimbursement barriers for Johnson & Johnson neuroscience therapies. Managing patient access across Minneapolis, Milwaukee, Des Moines, and Fargo.
Field Reimbursement Manager – Neuroscience
Field Reimbursement Manager educating Florida healthcare providers on reimbursement and access. Resolving coverage barriers for J&J neuroscience patients across the Tampa territory.
Field Reimbursement Manager – Neuroscience
Field Reimbursement Manager helping healthcare providers overcome reimbursement barriers for Johnson & Johnson neuroscience therapies. Managing Philadelphia territory relationships, education, access support, and payer issues.
Auction Manager
Auction Manager owning seller relationships and guiding enthusiast-car listings from submission to sale. Supporting Cars & Bids’ growing online marketplace through consultative sales and high-touch service.