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The Care Integration Team Manager is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high needs patients using a team-based approach to ensure patients receive the individualized care and services they need to reach optimal health. The Manager is also responsible for building strong partnerships with clinical-operational market leaders on Care Integration Team foundational program and strategic opportunities for managing populations and coordinating care to reduce acute and post-acute care utilization. The Manager role is hybrid with travel requirements to preferred healthcare facilities in the community, alongside clinical market leader, to develop clinical partnerships for timely access to patient information, clinical collaboration on patient care, and patient centered resources.
As a guideline, this role involves spending 50% of the time on operational excellence and program delivery, 25% on relationships, and 25% on community partnerships.
Major Duties and Responsibilities
·Oversees day-to-day operations, quality chart audit reviews, recruiting/hiring, team management, and overall performance for Care Integration Team associates in the market.
·Ensures clinical program integrity at the market level and addresses performance and program improvement opportunities, escalating to Divisional Director as appropriate.
·Collaborates with market leader/key stakeholders to design market specific strategies, data analytics, and create action plans that will reduce acute and post-acute care utilization.
·Solicits/shares feedback with market leaders on team-based focus with attention given to success and opportunities to improve one care team culture and collaboration on high-risk patient management, at the market level. Effectively prioritizes patients with the market leaders who benefit the most from care management programs.
·Initiates and maintains relationships with community partners, including key community organizations, Centerwell organizations (home health and pharmacy), and health care systems for strong clinical collaboration that will improve patient experience and overall population health outcomes.
·Accountability to key population health metrics, including quality, utilization and financial measures.
Required Qualifications
Benefits
Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Scheduled Weekly Hours
40Equal 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.
Full Time
Insurance
$104k-130k (estimate)
03/15/2024
06/11/2024
humana.com
TEMPE, AZ
15,000 - 50,000
1961
ALISON RITCHHART
>$50B
Insurance
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on puttin...g the customer first.
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