Role: Care Manager
Assignment: American Eldercare
Location: Tallahassee, FL
We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our consumers, providers, employers, agents and others we work with. At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our members, employers, providers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.
Assignment Capsule
We are currently seeking a Care Manager to plan, coordinate, provide, and manage services to members to maximize independent living status in an environment that promotes conflict free case management.
Job Functions
* Coordinates development of care plan for members by meeting with members, caregivers, healthcare providers, and appropriate individuals to integrate services required to effectively meet the member’s needs.
* Coordinates formal and informal services and resources with in- and out-of-network providers and monitors delivery to ensure effective and timely service provision in accordance with care plan.
* Orients new members and/or their caregivers to provide full explanation of individualized care plan and the use of the handbook and provider directory.
* Advocates for the members’ needs, addresses concerns and resolves.
* Advocates for members that are temporarily housed in acute care facilities by communicating weekly and as needed with the facilities to identify and document barriers and to play a role in discharge planning to ensure placement in a less restrictive setting.
* Visits members on a scheduled and as-need basis to monitor, evaluate, and record client progress according to measurable goals described in treatment and care plan and modifies treatment plans to comply with changes in clients' status
* Documents all interventions, interactions within 5 calendar days of event and in compliance with all contract standards & expectations, and company requirements.
* Facilitates the completion of Medicaid and other benefits programs eligibility application process for members and monitors the process.
* Attends a minimum of one networking event each month to promote AEC services within the community.
Key Competencies
* Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions.
* Accountability: Meets established expectations and takes responsibility for achieving results; encourages others to do the same.
* Customer Focus:Connects meaningfully with customers to build emotional engagement and customer advocacy. Develops and applies deep customer knowledge and intimacy to develop and deliver products, services, and interactions that provide value beyond expectations.
* Executes for Results: Effectively leverages resources to create exceptional outcomes. Determines the best course of action when facing ambiguity. Anticipates and constructively resolves barriers and constraints.
Role Essentials
* Bachelor’s in Social Work, Sociology, Psychology, Gerontology or a related field.
* Two or more years of case management experience.
* 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 100,000/300,000/100,000 limits.
* ACHA Level II Background clearance.
* Current CPR certification.
* 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 detailed oriented.
* Excellent written and verbal communication skills.
Role Desirables
* Bilingual a plus.
* Master's Degree
* DOEA 701B Assessment experience.
Additional Information
At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.
**Job** *Clinical Innovations and Health Practitioners*
**Title:** *Care Manager - American Eldercare (Tallahassee, FL)*
**Location:** *FL-Tallahassee*
**Requisition ID:** *145040*