Hybrid Remote Manager, Service Coordination (Virginia Medicaid) – RN – VA, DC, MD, WV, KY, TN, NC

Job Overview

  • Clinical License RN
  • State(s) DC, KY, MD, NC, TN, VA, WV

About this job

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

Humana Healthy Horizons in Virginia is seeking a Manager, Service Coordination (Manager, Care Coaching) who will lead teams of Service Coordinators (Care Coaches) responsible for the oversight of evaluation of member’s needs and requirements to achieve and/or maintain optimal wellness state. The Manager, Service Coordination (Manager, Care Coaching) 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.

 

  • Oversees the service coordination staff and monitors assessments and evaluation of members’ needs

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

Humana Healthy Horizons in Virginia is seeking a Manager, Service Coordination (Manager, Care Coaching) who will lead teams of Service Coordinators (Care Coaches) responsible for the oversight of evaluation of member’s needs and requirements to achieve and/or maintain optimal wellness state. The Manager, Service Coordination (Manager, Care Coaching) 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.

 

  • Oversees the service coordination staff and monitors assessments and evaluation of members’ needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families towards and facilitates interaction with resources appropriate for the care and wellbeing of members.
  • Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area and requires cross departmental collaboration.
  • Conducts briefings, and area meetings, maintains frequent contact with other managers across the department.
  • May participate in Interdisciplinary team meetings.
  • Develops service coordination policies and procedures to ensure compliance with state and federal requirements and incorporate industry best practices.
  • Supports leadership in meeting goals of the department/market.

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).
  • Bachelor’s degree in human services, social sciences, or a health-related field.
  • Three (3) or more years of professional experience working with complex populations or in manage care settings.
  • Two (2) or more years of management or supervisory experience.
  • Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
  • Proficiency in analyzing and interpreting data trends.
  • Progressive business consulting and/or operational leadership experience.
  • Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport.
  • 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

  • Master’s degree in human services, social sciences, or health-related field.
  • Care Management certification (CCM).
  • Active, unrestricted, Registered Nurse (RN) license or Licensed Mental Health Professional (LMHP) in the Commonwealth of Virginia.
  • Three (3) or more years of managed care experience in Medicare and/or Medicaid, specifically in the delivery of care for elderly or special needs populations such as the Aged, Blind and Disabled (ABD) and those enrolled in Long-Term Services and Supports (LTSS) Waiver Services, in hospice and/or in nursing facilities.
  • Proficiency in analyzing and interpreting financial trends.
  • Previous experience in utilization management, discharge planning and/or home health or rehabilitation.
  • Experience with initiating services plan for members.
  • Experience with health promotion, coaching and wellness.
  • Health Plan experience.

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 15.

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.

 

$69,800 – $96,200 per year

 

This 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.

 

 

 

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