Hybrid Bilingual Manager, Care Integration Team

Manager Care / Case Management

The Manager Care / Case Management in Tampa area 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 / Conviva 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

Preferred Qualifications

Additional Information

Hybrid Office Workstyle : Combination in home office work and local travel to clinics in the Tampa area

Benefits

About Us

About Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.

About CenterWell, a Humana company : CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE : HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

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.