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)
.
Humana Healthy Horizons in Virginia is seeking an Associate Director, Care Management (LTSS/ABD) who will lead teams of healthcare professionals responsible for care management. They will lead and guide others in providing integrated services for the clinical teams. The Associate Director, Care Management requires a solid understanding of how organization capabilities interrelate across department(s).
Responsibilities
Manage day-to-day operations for Long-Term Services and Supports and Aged, Blind or Disabled (LTSS/ABD) clinical care management team.
Provide ongoing associate coaching and feedback to enhance associate contribution, competency, and performance.
Oversee the assessment and evaluation of members' needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and wellbeing of members.
Participate in Care Management collaborative meetings as required by the Virginia Department of Medical Assistance (DMAS).
Make decisions related to identifying and resolving complex technical and operational problems within department(s) and lead multiple managers or highly specialized professional associates.
Monitor data sharing among internal and external resources to ensure service integration, continuity of care, challenges, risk, and opportunities.
Lead a team that delivers care management services to our members with an agile approach in partnership with technology, provider relations, and other key stakeholders while managing operational risks and contractual/regulatory risks.
Develop and achieve performance metrics for a fast-paced comprehensive case management environment.
Assure contractual compliance with mandated and corporate policies regarding other departmental areas such as medical management, utilization management, population health, and quality.
May require cross-functional departmental/market collaborations and conduct briefings and area meetings; maintain frequent communication with team members.
Attract, develop, empower, and inspire talent to help Humana Healthy Horizons deliver on their contractual and business strategy.
Develop educational and training programs for the LTSS/ABD care management team.
Collaborate with other Humana leadership to identify the clinical tools and systems to support LTSS Care Management activities.
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)
.
An active, unrestricted, Registered Nurse (RN) license or Licensed Mental Health Professional (LMHP) in the Commonwealth of Virginia.
Five (5) years of professional experience working with complex populations or in managed care settings.
Three (3) years of management or supervisory experience.
Proficiency in analyzing and interpreting data trends.
Progressive business consulting and/or operational leadership experience.
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
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.
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 5.
Job Type: Full-time
Pay: $103,000.00 - $130,000.00 per year
Benefits:
401(k)
401(k) matching
Dental insurance
Employee assistance program
Employee discount
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Parental leave
Professional development assistance
Retirement plan
Tuition reimbursement
Vision insurance
Schedule:
8 hour shift
Day shift
Monday to Friday
Supplemental Pay:
Bonus opportunities
License/Certification:
RN License in the Commonwealth of Virginia? (Required)
Ability to Commute:
Virginia (Required)
Ability to Relocate:
Virginia: Relocate before starting work (Required)
Willingness to travel:
25% (Required)
Work Location:
In person
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