88 Health Care jobs in Carol City
Behavioral Health Care Coordinator
Posted today
Job Viewed
Job Description
The Behavioral Health Care Coordinator plays a pivotal role as a core member of the collaborative care team, working alongside the enrollee's medical provider, mental health team, and the larger Concierge Care Coordination team. This position is responsible for coordinating and supporting the mental and physical health care of enrollees within an assigned behavioral health population caseload. The coordinator collaborates with medical providers and, when appropriate, other mental health providers, to manage care for all lines of business, including managed care contract programs that serve adults and children with severe mental illness (SMI).
Responsibilities
+ Lead a multidisciplinary team to identify high-risk clients, address care gaps, and collaborate with providers to enhance patient outcomes and care quality.
+ Manage services for medical, behavioral, and substance use needs, including crisis intervention, discharge planning, and complex case management.
+ Engage with Medical Directors and care management staff to direct appropriate utilization and data capture.
+ Educate members, providers, and team members on care coordination services and the proper use of these services, including reducing inappropriate admissions and placements.
+ Conduct thorough needs assessments, including risk stratification, to determine health, psychological, educational, and social needs.
+ Review the daily census for enrollees admitted to the hospital within your panel, assess the need for ongoing care coordination, and facilitate discharge planning.
+ Conduct outreach to enrollees with patterns of emergency room visits to identify contributing factors and develop strategies to reduce avoidable admissions.
+ Develop individualized care plans in collaboration with physicians and enrollees, setting specific, measurable, achievable, realistic, and time-bound (SMART) goals.
+ Participate in team huddles and multidisciplinary team conferences to review strategies, address immediate needs, and develop action plans for quality care.
+ Identify and assess barriers when members do not meet treatment goals, fail to follow care plans, or miss appointments.
+ Provide education on disease processes, healthy lifestyle changes, and self-management strategies consistent with clinical practice guidelines.
+ Deliver brief behavioral interventions using evidence-based techniques such as motivational interviewing, problem-solving treatment, or behavioral activation.
+ Conduct in-home assessments as needed to evaluate the member's home environment for safety, setting appropriateness, and the availability of needed supplies and medications.
+ Monitor resource utilization, including hospitalizations and long-term care services, to promote optimal use consistent with organizational goals.
+ Maintain accurate documentation in compliance with quality standards and accreditation requirements for care management programs.
+ Serve as a liaison between members, providers, medical directors, and external organizations to coordinate care and resolve authorization issues.
Essential Skills
+ Case management
+ Behavioral health
+ Care coordination
+ Chronic disease management
+ Plan of care management
+ Managed care experience
+ Medicaid knowledge
+ Needs assessment
Additional Skills & Qualifications
+ Bachelor's Degree in social work and/or Nursing
+ Master's Degree in social work (MSW) or Nursing (Preferred)
+ Psychiatric/Mental Health Nursing Certification (Preferred)
+ Registered Nurse licensure in the state of Florida, or State Licensure in Social Work or related field (Preferred)
+ Certified Case Manager (Preferred)
+ License Clinical Social Work (LCSW), Licensed Mental Health Counselor (LMHC) - (A Plus)
+ Psychiatric- Mental Health Nursing Certification (A Plus)
+ Certified Addictions Registered Nurse (CARN) (A Plus)
+ 3-5 years of clinical experience
+ 3-5 years of experience in a managed care, health plan, or insurance setting
+ Experience with Utilization Management and Care Coordination
+ Knowledge of Medicaid/Medicare Regulations
+ Knowledge of Microsoft Office and internet software
+ Knowledge of EPIC and similar systems (preferred)
Work Environment
This role offers a hybrid work environment, with 1 day in the office, either Tuesday or Thursday. When working from home, candidates must have a private space with a closed door to maintain confidentiality due to members' private health matters. Equipment necessary for the role will be provided.
Pay and Benefits
The pay range for this position is $38.00 - $38.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a hybrid position in Sunrise,FL.
Application Deadline
This position is anticipated to close on Aug 12, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email (% ) for other accommodation options.
Behavioral Health Care Coordinator

Posted 2 days ago
Job Viewed
Job Description
The Behavioral Health Care Coordinator plays a pivotal role as a core member of the collaborative care team, working alongside the enrollee's medical provider, mental health team, and the larger Concierge Care Coordination team. This position is responsible for coordinating and supporting the mental and physical health care of enrollees within an assigned behavioral health population caseload. The coordinator collaborates with medical providers and, when appropriate, other mental health providers, to manage care for all lines of business, including managed care contract programs that serve adults and children with severe mental illness (SMI).
Responsibilities
+ Lead a multidisciplinary team to identify high-risk clients, address care gaps, and collaborate with providers to enhance patient outcomes and care quality.
+ Manage services for medical, behavioral, and substance use needs, including crisis intervention, discharge planning, and complex case management.
+ Engage with Medical Directors and care management staff to direct appropriate utilization and data capture.
+ Educate members, providers, and team members on care coordination services and the proper use of these services, including reducing inappropriate admissions and placements.
+ Conduct thorough needs assessments, including risk stratification, to determine health, psychological, educational, and social needs.
+ Review the daily census for enrollees admitted to the hospital within your panel, assess the need for ongoing care coordination, and facilitate discharge planning.
+ Conduct outreach to enrollees with patterns of emergency room visits to identify contributing factors and develop strategies to reduce avoidable admissions.
+ Develop individualized care plans in collaboration with physicians and enrollees, setting specific, measurable, achievable, realistic, and time-bound (SMART) goals.
+ Participate in team huddles and multidisciplinary team conferences to review strategies, address immediate needs, and develop action plans for quality care.
+ Identify and assess barriers when members do not meet treatment goals, fail to follow care plans, or miss appointments.
+ Provide education on disease processes, healthy lifestyle changes, and self-management strategies consistent with clinical practice guidelines.
+ Deliver brief behavioral interventions using evidence-based techniques such as motivational interviewing, problem-solving treatment, or behavioral activation.
+ Conduct in-home assessments as needed to evaluate the member's home environment for safety, setting appropriateness, and the availability of needed supplies and medications.
+ Monitor resource utilization, including hospitalizations and long-term care services, to promote optimal use consistent with organizational goals.
+ Maintain accurate documentation in compliance with quality standards and accreditation requirements for care management programs.
+ Serve as a liaison between members, providers, medical directors, and external organizations to coordinate care and resolve authorization issues.
Essential Skills
+ Case management
+ Behavioral health
+ Care coordination
+ Chronic disease management
+ Plan of care management
+ Managed care experience
+ Medicaid knowledge
+ Needs assessment
Additional Skills & Qualifications
+ Bachelor's Degree in social work and/or Nursing
+ Master's Degree in social work (MSW) or Nursing (Preferred)
+ Psychiatric/Mental Health Nursing Certification (Preferred)
+ Registered Nurse licensure in the state of Florida, or State Licensure in Social Work or related field (Preferred)
+ Certified Case Manager (Preferred)
+ License Clinical Social Work (LCSW), Licensed Mental Health Counselor (LMHC) - (A Plus)
+ Psychiatric- Mental Health Nursing Certification (A Plus)
+ Certified Addictions Registered Nurse (CARN) (A Plus)
+ 3-5 years of clinical experience
+ 3-5 years of experience in a managed care, health plan, or insurance setting
+ Experience with Utilization Management and Care Coordination
+ Knowledge of Medicaid/Medicare Regulations
+ Knowledge of Microsoft Office and internet software
+ Knowledge of EPIC and similar systems (preferred)
Work Environment
This role offers a hybrid work environment, with 1 day in the office, either Tuesday or Thursday. When working from home, candidates must have a private space with a closed door to maintain confidentiality due to members' private health matters. Equipment necessary for the role will be provided.
Pay and Benefits
The pay range for this position is $38.00 - $38.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a hybrid position in Sunrise,FL.
Application Deadline
This position is anticipated to close on Jul 31, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email (% ) for other accommodation options.
Telephonic Behavior Health Care Manager

Posted 2 days ago
Job Viewed
Job Description
Are you a transitioning military service member or a Military Spouse looking for an internship that supports the goal to put health first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members that are eligible to participate in the DoD SkillBridge Internship, or military spouses that are eligible to participate in the Military Spouse Fellowship, with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract requirements. During the internship you will assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families towards and facilitates interaction with resources appropriate for the care and wellbeing of members. If you are interested in this position, you will be required to confirm eligibility to participate in the DoD SkillBridge Internship and/or the Military Spouse Fellowship.
The DOD SkillBridge Internship Program provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
The Military Spouse Fellowship Program connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
The Telephonic Behavioral Health Care Manager Intern will utilize Humana's Medicaid training and engage formerly acquired skillsets to:
+ Perform care management of pediatric members (under 21) who utilize Applied Behavioral Analysis (ABA) services and employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.
+ Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess medical/social/BH needs and addresses gaps in care.
+ Participate in all scheduled interagency planning meetings to discuss progress, treatment planning, and discharge planning.
+ Refer to Humana Valued Added Benefits as appropriate (Mom's meals, Modivcare, etc.).
+ Collaborate with outside parties to include but not limited to: ABA providers, BH vendors (Carelon/ABH), schools, managing entities, Department Children and Family (DCF), Department Juvenile Justice (DJJ), Agency for Persons with Disability (APD).
**Use your skills to make an impact**
**Required Qualifications**
Must meet **one** of the following:
+ Bachelor's degree in social work or behavioral health-related field
+ Active licensed Registered Nurse, RN in the state of Florida without disciplinary
Must meet **all** of the following:
+ Transitioning Service Member eligible to participate in SkillBridge or military spouse eligible to participate in the military spouse fellowship
+ Minimum one, (1) year of experience working in social work or a behavioral health-related field.
+ Minimum one, (1) year of experience working with the pediatric population in a professional setting (under 21).
+ Minimum one, (1) year of case management experience.
+ ACHA Level II Background Check is required.
**Preferred Qualifications**
+ Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university.
+ License in SW or BH related field (LMHC, LMFT, LCSW).
+ CCM certification.
+ Knowledge/experience in navigation of community health and social service agencies and additional community resources.
+ Experience in dealing with complaints and grievances related to members care and/or coordination of care.
+ Experience in participation in interagency meetings with community providers/members/families to address members care and tx goals.
+ 1 or more years working with members receiving ABA services.
**Additional Information**
**The DOD SkillBridge Internship Program** provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
**The Military Spouse Fellowship Program** connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
+ **Workstyle:** Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
+ **Location:** Must reside in Florida
+ **Typical Schedule:** Monday - Friday, 8:30 am - 5:00 pm CST or EST.
**Remote Work at Home Guidance:** 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 recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
**SSN Alert** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
**Ethics Section 1121 of the Louisiana Code of Governmental Ethics** states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
1
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
?
**Equal 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
Telephonic Behavior Health Care Manager

Posted 2 days ago
Job Viewed
Job Description
Are you a transitioning military service member or a Military Spouse looking for an internship that supports the goal to put health first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members that are eligible to participate in the DoD SkillBridge Internship, or military spouses that are eligible to participate in the Military Spouse Fellowship, with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract requirements. During the internship you will assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families towards and facilitates interaction with resources appropriate for the care and wellbeing of members. If you are interested in this position, you will be required to confirm eligibility to participate in the DoD SkillBridge Internship and/or the Military Spouse Fellowship.
The DOD SkillBridge Internship Program provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
The Military Spouse Fellowship Program connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
The Telephonic Behavioral Health Care Manager Intern will utilize Humana's Medicaid training and engage formerly acquired skillsets to:
+ Perform care management of pediatric members (under 21) who utilize Applied Behavioral Analysis (ABA) services and employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.
+ Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess medical/social/BH needs and addresses gaps in care.
+ Participate in all scheduled interagency planning meetings to discuss progress, treatment planning, and discharge planning.
+ Refer to Humana Valued Added Benefits as appropriate (Mom's meals, Modivcare, etc.).
+ Collaborate with outside parties to include but not limited to: ABA providers, BH vendors (Carelon/ABH), schools, managing entities, Department Children and Family (DCF), Department Juvenile Justice (DJJ), Agency for Persons with Disability (APD).
**Use your skills to make an impact**
**Required Qualifications**
Must meet **one** of the following:
+ Bachelor's degree in social work or behavioral health-related field
+ Active licensed Registered Nurse, RN in the state of Florida without disciplinary
Must meet **all** of the following:
+ Transitioning Service Member eligible to participate in SkillBridge or military spouse eligible to participate in the military spouse fellowship
+ Minimum one, (1) year of experience working in social work or a behavioral health-related field.
+ Minimum one, (1) year of experience working with the pediatric population in a professional setting (under 21).
+ Minimum one, (1) year of case management experience.
+ ACHA Level II Background Check is required.
**Preferred Qualifications**
+ Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university.
+ License in SW or BH related field (LMHC, LMFT, LCSW).
+ CCM certification.
+ Knowledge/experience in navigation of community health and social service agencies and additional community resources.
+ Experience in dealing with complaints and grievances related to members care and/or coordination of care.
+ Experience in participation in interagency meetings with community providers/members/families to address members care and tx goals.
+ 1 or more years working with members receiving ABA services.
**Additional Information**
**The DOD SkillBridge Internship Program** provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
**The Military Spouse Fellowship Program** connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
+ **Workstyle:** Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
+ **Location:** Must reside in Florida
+ **Typical Schedule:** Monday - Friday, 8:30 am - 5:00 pm CST or EST.
**Remote Work at Home Guidance:** 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 recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
**SSN Alert** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
**Ethics Section 1121 of the Louisiana Code of Governmental Ethics** states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
1
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
?
**Equal 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
Telephonic Behavior Health Care Manager

Posted 2 days ago
Job Viewed
Job Description
Are you a transitioning military service member or a Military Spouse looking for an internship that supports the goal to put health first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members that are eligible to participate in the DoD SkillBridge Internship, or military spouses that are eligible to participate in the Military Spouse Fellowship, with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract requirements. During the internship you will assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families towards and facilitates interaction with resources appropriate for the care and wellbeing of members. If you are interested in this position, you will be required to confirm eligibility to participate in the DoD SkillBridge Internship and/or the Military Spouse Fellowship.
The DOD SkillBridge Internship Program provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
The Military Spouse Fellowship Program connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
The Telephonic Behavioral Health Care Manager Intern will utilize Humana's Medicaid training and engage formerly acquired skillsets to:
+ Perform care management of pediatric members (under 21) who utilize Applied Behavioral Analysis (ABA) services and employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.
+ Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess medical/social/BH needs and addresses gaps in care.
+ Participate in all scheduled interagency planning meetings to discuss progress, treatment planning, and discharge planning.
+ Refer to Humana Valued Added Benefits as appropriate (Mom's meals, Modivcare, etc.).
+ Collaborate with outside parties to include but not limited to: ABA providers, BH vendors (Carelon/ABH), schools, managing entities, Department Children and Family (DCF), Department Juvenile Justice (DJJ), Agency for Persons with Disability (APD).
**Use your skills to make an impact**
**Required Qualifications**
Must meet **one** of the following:
+ Bachelor's degree in social work or behavioral health-related field
+ Active licensed Registered Nurse, RN in the state of Florida without disciplinary
Must meet **all** of the following:
+ Transitioning Service Member eligible to participate in SkillBridge or military spouse eligible to participate in the military spouse fellowship
+ Minimum one, (1) year of experience working in social work or a behavioral health-related field.
+ Minimum one, (1) year of experience working with the pediatric population in a professional setting (under 21).
+ Minimum one, (1) year of case management experience.
+ ACHA Level II Background Check is required.
**Preferred Qualifications**
+ Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university.
+ License in SW or BH related field (LMHC, LMFT, LCSW).
+ CCM certification.
+ Knowledge/experience in navigation of community health and social service agencies and additional community resources.
+ Experience in dealing with complaints and grievances related to members care and/or coordination of care.
+ Experience in participation in interagency meetings with community providers/members/families to address members care and tx goals.
+ 1 or more years working with members receiving ABA services.
**Additional Information**
**The DOD SkillBridge Internship Program** provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
**The Military Spouse Fellowship Program** connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
+ **Workstyle:** Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
+ **Location:** Must reside in Florida
+ **Typical Schedule:** Monday - Friday, 8:30 am - 5:00 pm CST or EST.
**Remote Work at Home Guidance:** 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 recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
**SSN Alert** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
**Ethics Section 1121 of the Louisiana Code of Governmental Ethics** states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
1
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
?
**Equal 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
Telephonic Behavior Health Care Manager

Posted 2 days ago
Job Viewed
Job Description
Are you a transitioning military service member or a Military Spouse looking for an internship that supports the goal to put health first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members that are eligible to participate in the DoD SkillBridge Internship, or military spouses that are eligible to participate in the Military Spouse Fellowship, with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract requirements. During the internship you will assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families towards and facilitates interaction with resources appropriate for the care and wellbeing of members. If you are interested in this position, you will be required to confirm eligibility to participate in the DoD SkillBridge Internship and/or the Military Spouse Fellowship.
The DOD SkillBridge Internship Program provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
The Military Spouse Fellowship Program connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
The Telephonic Behavioral Health Care Manager Intern will utilize Humana's Medicaid training and engage formerly acquired skillsets to:
+ Perform care management of pediatric members (under 21) who utilize Applied Behavioral Analysis (ABA) services and employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.
+ Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess medical/social/BH needs and addresses gaps in care.
+ Participate in all scheduled interagency planning meetings to discuss progress, treatment planning, and discharge planning.
+ Refer to Humana Valued Added Benefits as appropriate (Mom's meals, Modivcare, etc.).
+ Collaborate with outside parties to include but not limited to: ABA providers, BH vendors (Carelon/ABH), schools, managing entities, Department Children and Family (DCF), Department Juvenile Justice (DJJ), Agency for Persons with Disability (APD).
**Use your skills to make an impact**
**Required Qualifications**
Must meet **one** of the following:
+ Bachelor's degree in social work or behavioral health-related field
+ Active licensed Registered Nurse, RN in the state of Florida without disciplinary
Must meet **all** of the following:
+ Transitioning Service Member eligible to participate in SkillBridge or military spouse eligible to participate in the military spouse fellowship
+ Minimum one, (1) year of experience working in social work or a behavioral health-related field.
+ Minimum one, (1) year of experience working with the pediatric population in a professional setting (under 21).
+ Minimum one, (1) year of case management experience.
+ ACHA Level II Background Check is required.
**Preferred Qualifications**
+ Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university.
+ License in SW or BH related field (LMHC, LMFT, LCSW).
+ CCM certification.
+ Knowledge/experience in navigation of community health and social service agencies and additional community resources.
+ Experience in dealing with complaints and grievances related to members care and/or coordination of care.
+ Experience in participation in interagency meetings with community providers/members/families to address members care and tx goals.
+ 1 or more years working with members receiving ABA services.
**Additional Information**
**The DOD SkillBridge Internship Program** provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
**The Military Spouse Fellowship Program** connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
+ **Workstyle:** Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
+ **Location:** Must reside in Florida
+ **Typical Schedule:** Monday - Friday, 8:30 am - 5:00 pm CST or EST.
**Remote Work at Home Guidance:** 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 recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
**SSN Alert** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
**Ethics Section 1121 of the Louisiana Code of Governmental Ethics** states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
1
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
?
**Equal 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
Telephonic Behavior Health Care Manager

Posted 2 days ago
Job Viewed
Job Description
Are you a transitioning military service member or a Military Spouse looking for an internship that supports the goal to put health first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members that are eligible to participate in the DoD SkillBridge Internship, or military spouses that are eligible to participate in the Military Spouse Fellowship, with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract requirements. During the internship you will assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families towards and facilitates interaction with resources appropriate for the care and wellbeing of members. If you are interested in this position, you will be required to confirm eligibility to participate in the DoD SkillBridge Internship and/or the Military Spouse Fellowship.
The DOD SkillBridge Internship Program provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
The Military Spouse Fellowship Program connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
The Telephonic Behavioral Health Care Manager Intern will utilize Humana's Medicaid training and engage formerly acquired skillsets to:
+ Perform care management of pediatric members (under 21) who utilize Applied Behavioral Analysis (ABA) services and employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.
+ Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess medical/social/BH needs and addresses gaps in care.
+ Participate in all scheduled interagency planning meetings to discuss progress, treatment planning, and discharge planning.
+ Refer to Humana Valued Added Benefits as appropriate (Mom's meals, Modivcare, etc.).
+ Collaborate with outside parties to include but not limited to: ABA providers, BH vendors (Carelon/ABH), schools, managing entities, Department Children and Family (DCF), Department Juvenile Justice (DJJ), Agency for Persons with Disability (APD).
**Use your skills to make an impact**
**Required Qualifications**
Must meet **one** of the following:
+ Bachelor's degree in social work or behavioral health-related field
+ Active licensed Registered Nurse, RN in the state of Florida without disciplinary
Must meet **all** of the following:
+ Transitioning Service Member eligible to participate in SkillBridge or military spouse eligible to participate in the military spouse fellowship
+ Minimum one, (1) year of experience working in social work or a behavioral health-related field.
+ Minimum one, (1) year of experience working with the pediatric population in a professional setting (under 21).
+ Minimum one, (1) year of case management experience.
+ ACHA Level II Background Check is required.
**Preferred Qualifications**
+ Master's degree in a behavioral-health field, such as social work, psychology, or related health discipline from an accredited university.
+ License in SW or BH related field (LMHC, LMFT, LCSW).
+ CCM certification.
+ Knowledge/experience in navigation of community health and social service agencies and additional community resources.
+ Experience in dealing with complaints and grievances related to members care and/or coordination of care.
+ Experience in participation in interagency meetings with community providers/members/families to address members care and tx goals.
+ 1 or more years working with members receiving ABA services.
**Additional Information**
**The DOD SkillBridge Internship Program** provides an opportunity for transitioning military service members to gain civilian work experience with an employer for a period between 90 and 180 days upon approval.
**The Military Spouse Fellowship Program** connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11 weeks.
+ **Workstyle:** Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
+ **Location:** Must reside in Florida
+ **Typical Schedule:** Monday - Friday, 8:30 am - 5:00 pm CST or EST.
**Remote Work at Home Guidance:** 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 recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
**SSN Alert** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
**Ethics Section 1121 of the Louisiana Code of Governmental Ethics** states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
1
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
?
**Equal 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
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Behavioral Health Care Manager l

Posted 2 days ago
Job Viewed
Job Description
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
**Work Shift:** 8AM -5PM CST
**Behavioral Health Care Manager l**
The **Behavioral Health Care Manager I** is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.
**How You Will Make an Impact**
Primary duties may include, but are not limited to:
+ Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract.
+ Refers cases to Peer Reviewers as appropriate.
+ Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.
**Minimum Requirements:**
Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background. Current active unrestricted license, such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required. Licensure is a requirement for this position. However, for states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.
**Preferred Skills, Capabilities and Experiences:**
+ Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
+ Proficiency in Microsoft Office Products is preferred
_For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills._
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Health Services Administrator, RN Required

Posted 2 days ago
Job Viewed
Job Description
- Make a difference every day in the lives of the underserved
- Join a mission driven organization with a people first culture
- Excellent career growth opportunities
**Join us and find a career that supports:**
- Caring for overlooked, underserved, and vulnerable patients
- Diversity, equity, inclusion, and belonging
- Autonomy in a warm team environment
- Growth and training
**Perks and Benefits**
In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:
- DailyPay, receive your money as you earn it!
- Tuition Assistance and dependent Scholarships
- Employee Assistance Program (EAP) including free counseling and health coaching
- Company paid life insurance
- Tax free Health Spending Accounts (HSA)
- Wellness program featuring fitness memberships and product discounts
- Preferred banking partnership and discounted rates for home and auto loans
*Eligibility for perks and benefits varies based on employee type and length of service.
**Why Us**
**Now is your moment to make a difference in the lives of the underserved.**
If there is one unifying characteristic of everyone on our team, it is the deep desire to make a difference by helping society's most vulnerable and often overlooked individuals. Every day we have the distinct honor and responsibility to show up with non-judgmental compassion to provide hope and healing to those who need it most. For those whose calling it is to serve others, now is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and innovation, to live our mantra to "Always Do The Right Thing!", and to collectively do our part to heal the world, one patient at a time.
Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan.
We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support.
**How you make a difference**
As a Health Services Administrator RN, you'll oversee and assess the Health Care Delivery Program, adhering closely to State and Local Regulations. Your role involves ensuring that medical, dental, and mental health program initiatives align with company and facility policies, while also meeting ACA, NCCHC, and State accreditation standards for comprehensive compliance. With your expertise, you'll navigate the complex landscape of healthcare administration to maintain the highest quality of care within your organization.
**Key Responsibilities**
+ Supervise program implementation and efficiency, including financial evaluation and procedural improvements, while ensuring adherence to company policies and regulatory standards.
+ Foster strong relationships with internal and external stakeholders, coordinating recruitment, training, and performance evaluations, and maintaining open communication channels.
+ Manage all aspects of medical personnel licensure, insurance coverage, and compliance, overseeing contracted services and ensuring accurate reporting and record-keeping.
+ Monitor and optimize healthcare utilization, from pharmacy formulary adherence to inpatient hospitalizations, promoting quality care and cost-effectiveness.
+ Serve as a liaison for accreditation processes, participate in professional development activities, and drive quality improvement initiatives through active engagement in audits and adherence to industry standards.
**Qualifications & Requirements**
Education
+ Bachelor's Degree in Nursing
Experience
+ Delivery and administration of correctional medical, dental, and mental health care recommended.
+ Three years administrative, management and supervisory experience.
+ Sound decision-making skills are mandatory.
+ Organizational experience in operations and planning required.
+ Experience in Managing budgets and analyzing contracts preferred.
Licenses/Certifications
+ CPR certification.
**We are an Equal Employment Opportunity Employer**
We are committed to fostering, cultivating, and preserving a culture of uniqueness.
We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees.
**We encourage you to apply!** If you are excited about a role but your experience doesn't seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.
Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description.
We are an Affirmative Action Employer in accordance with applicable state and local laws.
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Home Health Wound Ostomy Care RN
Posted today
Job Viewed
Job Description
Become a part of our caring community and help us put health first
The Home Health Wound Ostomy Care RN is a specialized nursing position primarily focused on assessing documentation from field staff and collaborating closely with physicians to manage patients with a variety of complex wounds and skin care needs. This role is integral in developing tailored treatment plans that not only adhere to medical prescriptions and best practices in wound care but also aim at controlling utilization to improve patient outcomes. The expertise of a Home Health Wound Care RN is crucial in effectively addressing everything from acute injuries to chronic ulcers, ensuring optimal care suited to each patient's specific conditions
The Home Health Wound Ostomy Care RN is a specialized nursing position primarily focused on assessing documentation from field staff and collaborating closely with physicians to manage patients with a variety of complex wounds and skin care needs. This role is integral in developing tailored treatment plans that not only adhere to medical prescriptions and best practices in wound care but also aim at controlling utilization to improve patient outcomes. The expertise of a Home Health Wound Care RN is crucial in effectively addressing everything from acute injuries to chronic ulcers, ensuring optimal care suited to each patient's specific conditions
Responsibilities:
-Develop and implement evidence-based wound care protocols and standardized best practices.
-
Assess and consult on chronic or acute wounds, including ulcers, burns, pressure injuries, diabetic foot wounds, and skin tears.
-
Implement strategies to accelerate wound healing and prevent infections.
-
Educate home health clinicians and physicians on proper wound management techniques.
-
Focus on care for patients with ostomies, such as colostomies or ileostomies.
-
Educate and support clinicians in ostomy care and manage related complications.
-
Ensure patients receive appropriate ostomy care at home.
-
Address issues related to urinary and fecal incontinence.
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Provide strategies and support to improve patients' lifestyle and quality of life.
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Work closely with the Director of Nursing, Case Managers, and interdisciplinary teams including LPNs, NPs, physicians, dieticians, and therapists.
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Collaborate with post-acute providers to ensure cohesive and evidence-based care.
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Oversee and optimize utilization management processes within the organization.
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Ensure resource utilization is efficient, improving patient outcomes while managing costs.
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Adhere to the wound care formulary, recommending treatments consistent with agency guidelines.
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Conduct prospective, concurrent, and retrospective reviews to ensure treatment efficacy and adherence to evidence-based practices.
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Analyze wound healing rates and the effectiveness of specific wound care protocols.
Use your skills to make an impact
Qualifications:
-
Valid RN License in the state of Florida.
-
Certification as a Wound and Ostomy Care Nurse (CWOCN or WOCN).
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Proven experience in wound care, ostomy care, and continence management.
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Experience in a wound care or related clinical or home health setting.
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Strong understanding of best practices in wound management and treatment.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$70,500 - $96,900 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.
About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
?
Equal 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our