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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management, including assessing enrollees' needs, creating care plans, and collaborating with interdisciplinary teams. Proficient in navigating community health resources and ensuring compliance with HIPAA regulations.
Highest-signal resume keywords
Active Registered Nurse (RN) LicenseCare Management ExperienceMedicaid and Medicare CoordinationCase Management CertificationBilingual Spanish Speaking
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical ExperienceAssessment and EvaluationCare Plan DevelopmentCommunity Resource KnowledgeTelephonic AssessmentsFace-to-Face AssessmentsBarriers ResolutionInterdisciplinary CollaborationMicrosoft Office ApplicationsPHI / HIPAA Compliance
Soft Skills
CommunicationProblem-SolvingInterpersonal SkillsOrganizational Skills
Certifications & Qualifications
Case Management Certification
Industry Keywords
Community HealthSocial ServicesCare ManagementMedicaidMedicareSDOH CoordinationBehavioral HealthPhysical HealthEnvironmental HealthPsycho-Social Health
About the role
Key responsibilities & impact- Assess and evaluate enrollees' needs and requirements to achieve or maintain optimal wellness
- Guide enrollees and families toward appropriate care and wellbeing resources
- Manage enrollees' behavioral, physical, environmental, and psycho-social health needs
- Monitor assessments and evaluations to ensure progress toward desired outcomes
- Identify and resolve barriers to effective care
- Create enrollee/member care plans
- Perform telephonic and face-to-face assessments and evaluations
- Collaborate with providers and community services to promote quality and cost-effective outcomes
- Work with an interdisciplinary care management team including community health workers, housing support specialists, SDOH coordinators, and care management support assistants
- Determine when face-to-face enrollee support is required and coordinate in-person meetings
- Follow established guidelines and procedures
- Travel occasionally to Humana Oklahoma offices for meetings, training, or other business needs
Requirements
What you’ll need- Must reside in Oklahoma
- Active Registered Nurse (RN) license, Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW)
- Minimum 1-year clinical experience
- 2 or more years of care management
- Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs or benefits
- Knowledge of community health and social service agencies and additional community resources
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
- Case Management Certification preferred
- Bilingual Spanish Speaking preferred
- Minimum home internet speed of 25 Mbps download and 10 Mbps upload
- Dedicated work space without ongoing interruptions to protect member PHI / HIPAA information
Benefits
Comp & perks- Bonus incentive plan based on company and/or individual performance
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company and personal holidays
- Paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
- Home or hybrid home/office work arrangement
- Dedicated workspace and internet service requirements for working from home