Special Needs Plan- Support Social Services

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

The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Care Manager, Telephonic Behavioral Health 2 is a Licensed, Masters level, Social Worker who functions as a Support Social Services associate (Support SS) in our Special Needs Plan (SNP) program and serves as part of an interdisciplinary care team member working with other disciplines, such as nurse care managers, dieticians, behavioral health, and pharmacists to help promote and support member health and well-being.

This role requires the use of structured assessments along with critical thinking skills to determine appropriate interventions such as care coordination, health education, connection to community resources, full utilization of benefits and advocacy. This role requires effective and professional communication with providers, community resources, and other members of the interdisciplinary team to address member needs.

The Support SSs daily job duties include making outbound call attempts to members with social determinants of health (SDOH) needs to assess and assist with coordinating care with available plan benefits and/or appropriate community resources in a telephonic, call center, work from home environment. This role does not carry a caseload but may require additional member follow-up to ensure that all needs have been assessed and addressed.

The Support SS may also receive inbound calls from members needing additional assistance. This role is also responsible for assessing the member to determine if a referral to any other discipline is needed depending on member’s individualized needs.

Creating and updating member care plans may be required. Documentation in the member’s record is required to ensure CMS compliance, and accurately reflect work with members, providers, and other members of the interdisciplinary care team.

Use your skills to make an impact

Required Qualifications

• Master’s degree in social work from an accredited university

• Current, unincumbered, social work license;
  LMSW, LCSW, LICSW

• Must have passed ASWB Exam (Master, Advance Generalist, or Clinical level)

• Minimum 3 years of experience working as a social worker in a medical healthcare setting

• Proficient in Microsoft applications including Word, Outlook, Excel

• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously

• Must be willing to obtain/maintain social work licensure in multiple states, based on business need

Preferred Qualifications

• Experience working with geriatric, vulnerable, and/or low-income populations

• Licensure in LA, MD, MI, MS, NV, NM, OK, VA

• Bilingual English/Spanish

• Bilingual English/Creole

• Experience working with Medicare and Medicaid

Additional Information

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.

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.

Social Security Notification:

Humana values personal identity protection. Please be aware that…