Humana is looking for a Field Care Manager, Behavioral Health to join the IL Medicaid team. In this position, you will report to the Manager, Care Management and connect with members both face-to-face and telephonically. The Field Care Manager serves as the primary point of contact, providing integrated care to ensure members receive timely, high-quality, and coordination services that meet their needs. You will employ a variety of strategies, approaches, and techniques to manage a member's health issues and resolve barriers that hinder effective care. Using a holistic, person-centered approach, you will enhance behavioral health outcomes, reduce care gaps and support Illinois' FIDE population through comprehensive, integrated behavioral health care management.

Position Responsibilities: 

• Utilize high-quality, evidence-based behavioral health services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical and behavioral health providers. 

• Provide comprehensive, integrated support to members experiencing behavioral health conditions, including children, adolescents, adults with serious mental illness (SMI) and serious emotional disturbance (SED), Substance Use Disorders (SUD) and justice-involved members. 

• Engage members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination. 

• Coordinate behavioral health and medical services, ensuring appropriate provider engagement and adherence to treatment plans. 

• Improve member's health literacy while simultaneously addressing health related social needs to positively impact member's healthcare outcomes and well-being. 

• Serve as the driver of the member's interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery. 

• Facilitate ICT meetings, ensuring communication among providers, Service Coordinators, and Care Management Extenders. 

• Proactively support transition of care efforts. 

• Will work with autonomy but reach out when support is needed. 

• Collaborate with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members' preferences and needs. 

• Follow processes and procedures to ensure compliance with regulatory requirements by the Illinois Department of Human Services (IDHS), Center for Medicare and Medicaid Services (CMS) and the National Committee on Quality Assurance (NCQA).
  
  Upon hire, this role will be assigned to support either MLTSS, LTSS, PI or TOC based on business needs. 

Required Qualifications

• Must reside in Illinois

• Active Illinois license in LCSW, LMFT or LCPC (No supervisees or provisional licenses)  

• 2+ years of post-degree clinical experience in behavioral health setting. 

• Case management experience working with complex SMI, SUD, SED population. 

• Ability to travel to region-based facilities and homes for face-to-face assessments. 

• Ability to use a variety of electronic information applications/software programs including electronic medical records. 

• Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel. 

• Valid driver's license, car insurance, and reliable transportation. 

Preferred Qualifications

• Case Management Certification (CCM) 

• 3+ years of in-home assessment or care coordination experience.

• Experience working with Medicare, Medicaid and dual-eligible populations 

• Field Case Management Experience 

• Knowledge of community health and social service agencies and additional community resources 

• Previous managed care experience 

• Bilingual 

Additional Information

• Workstyle: This is a remote position that will require you to travel. 

• Travel: Up to 75% of the time for collaboration and face-to-face meetings and field interactions with staff, providers, members, and their families. 

• Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Central Standard Time (CST). 

• 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. 

• This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.