Director, Care Management

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The Director, Care Management leads interdisciplinary teams which can include nurses, social workers and behavioral health professionals, among others, that are responsible for care management. The Director, Care Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

The Director, Care Management oversees the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.

Responsibilities

• Oversee the assessment and evaluation of members’ needs and requirements to help achieve and/or maintain an optimal wellness state.

• Guide members and families to appropriate resources that support care, wellbeing, and overall health outcomes.

• Facilitate coordination and interaction with internal and external resources to meet member care needs.

• Lead the implementation of new and updated programs, as well as large-scale functional projects.

• Support and enhance technical and operational procedures and processes within care management.

• Implement strategic plans and provide input into functional strategy.

• Drive departmental goals and objectives to improve overall performance and outcomes.

• Direct and lead teams within the health solutions industry.

• Analyze and interpret trends to support decision-making, program effectiveness, and operational improvements.

• Utilize Microsoft Office applications, including Word, Excel, and Access, to support reporting, analysis, and communication.

• Contribute to an organization focused on continuously improving consumer experiences.

Use your skills to make an impact

Required Qualifications

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

8 or more years of technical

• 5 or more years of management experience, including 2 or more years of leading leaders

• Bachelor’s degree in business, finance or clinical field

• Prior work experience in the health solutions industry with demonstrated success directing and leading teams

• Expertise in developing and executing specific measurable goals focused on outcomes

• Understanding of and experience driving proactive performance management across a team of scale.

• Proficiency in analyzing and interpreting financial trends

• Experience developing and implementing complex resource plans

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and Access

Preferred Qualifications

• Master's Degree in Business Administration or a related field

• RN state license in field of study

Reporting Structure: This role reports to the Senior Vice President, Clinical Operations

Work Style: Fully remote in the contiguous US, with occasional travel to Humana's offices for training or meetings may be required.

Work Hours: Typical business hours are Monday-Friday, preferably aligned with CST or EST zone

Interview Format

As part of our hiring process, we use on-demand interview technology provided by HireVue, a third-party vendor. This platform allows our recruiters and hiring managers to evaluate candidates through a structured on-demand assessment.

If you are selected to move forward after the initial application you may prescreen and receive an invitation to complete an on-demand assessment featuring pre-set questions.The assessment typically takes 10–15 minutes to complete.

If you are asked to submit an on-demand interview, once your assessment has been reviewed, we will notify you regarding next steps in the interview process.

SSN Task via Workday

Should you receive a formal employment offer you will receive a request to enter your SSN into our Workday system to scan for duplicate profi

les

Work at Home Requirements: 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or…