Manager, Care Management; RN or SW) Macomb & Wayne Counties

Become a part of our caring community The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. The Manager, Care Management oversees the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.

• The Manager of Care Management:
  Requires cross-departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
• Responsible for and oversees delivery of care to all members served by the location.
• Reviews available information related to the member’s case, including disciplines required, to determine assessment needs.
• Monitor performance of staff including service performance and adherence to established care coordination benchmarks.
• Identify members for specific case management and / or disease management activities.
• Develop audit plans and tools for teams to ensure compliance with state contract on performance metrics and to ensure member needs are met.
• Develops reporting tools in collaboration with leadership to identify clinical performance.
• Responsible for interviewing, hiring, coaching, evaluating, and mentoring a diverse care coordination work force.
• Onboard new staff including but not limited all pre-employment human resource tasks, ordering of software, hardware, supplies and support technologies.
• Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions.
• Use your skills to make an impact

• 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 to include 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 all Microsoft Office applications, including Word, Excel and Power Point

• Minimum education of an Associate's Degree
• Certified Case Manager (CCM)
• 3+ years of previous management/supervisor level experience
• Experience with Medicaid Long Term Care
• Fully Bilingual in English and Spanish or Arabic

Work Location:

Michigan (Malcom and Wayne counties)

Work Style:
This is a remote- field position where employees perform their core duties from a home office with travel as needed to support Field Clinicians

Schedule/Time Zone:
Core hours are Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST) as well as occasional weekend hours, as needed, to support the business

Travel Requirements:
Up to 50% travel within Wayne and Macomb Counties for field-based interactions.

Number of Direct Reports: 13

Language Assessment Statement:
Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

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