Join our dedicated team and make a meaningful impact on health! As a Telephonic Behavioral Health Manager, you will play a crucial role within the Humana Military Case Management team, taking a comprehensive approach to Behavioral Health Case Management across the entire care continuum. You will engage directly with beneficiaries to understand and address their behavioral health needs, which may arise from referrals, predictive analytics, or diagnoses. Your mission will be to assist them in managing immediate care needs, following treatment plans, and developing effective coping strategies. Your primary responsibilities will include assessing, planning, coordinating, implementing, monitoring, and evaluating the care of TRICARE beneficiaries through phone interactions. You will empower each beneficiary in their self-care journey to improve their quality of life and achieve favorable clinical outcomes. As part of our Case Management team, you will serve as the primary liaison for beneficiaries, coordinating all necessary activities within the clinical arena. This involves close collaboration with Military Treatment Facilities (MTF), various Care Management programs (like Disease Management and Utilization Management), and healthcare providers to develop a cohesive care plan that meets all beneficiary needs. You will also be responsible for accurately documenting interventions and outcomes in the Case Management program, ensuring you remain within your professional scope of practice. Key Responsibilities: Carry out comprehensive assessments and craft personalized care plans for TRICARE beneficiaries, working closely with their physicians and care teams. Manage and authorize essential medical care in alignment with TRICARE guidelines to accommodate beneficiaries' health requirements. Provide telephonic care guidance and support to beneficiaries and their families, ensuring education and coordination as delineated in the care plan. Identify any gaps in care and evaluate needs for additional services in collaboration with Humana Government Business. Employ Motivational Interviewing and solution-focused strategies during all communications. Recognize and address Social Determinants of Health needs and local resources accessible to beneficiaries. Safeguard beneficiaries' privacy and confidentiality, truly advocating for their needs while adhering to ethical and regulatory standards. Follow organizational policies and performance standards in accordance with URAC, TRICARE Operations Manual (TOM), and Defense Health Agency (DHA) directives. Required Qualifications: A valid, unrestricted license as a Mental Health/Behavioral Health Professional (such as LCSW, LPC, LMHC, LMSW, or Clinical Psychologist) in your state of residency. At least 3 years of clinical experience, including experience in managed care. A commitment to achieving Certified Care Manager (CCM) certification within your first year of employment. Experience in mental health crisis intervention. Strong proficiency in Microsoft Office Suite, especially Word, Excel, OneNote, and Outlook. Exceptional verbal and written communication skills. Demonstrated organizational skills with the ability to manage multiple tasks efficiently. U.S. citizenship is required due to Department of Defense contract obligations. Ability to obtain government security clearance (via National Background Investigation Services). Please note that Humana Government Business cannot hire candidates residing in Puerto Rico due to government contract restrictions. Preferred Qualifications: Active certification as a Certified Care Manager (CCM). Experience in inpatient hospital case management. Familiarity with medical and behavioral health case management programs. Military experience is a plus. Knowledge of TRICARE policies and military healthcare systems. Experience with motivational interviewing techniques. Bilingual in Spanish and English is a desirable asset. Additional Information: Work Environment: This is a remote position. Schedule: Monday to Friday, with an 8-hour shift scheduled between 8:00 a.m. - 6:00 p.m. EST. Training: Mandatory training for the first four weeks from 8:00 a.m. - 5:00 p.m. EST. Remote Work Requirements: Internet service must have a minimum download speed of 25 Mbps and an upload speed of 10 Mbps; a wired, cable, or DSL connection is preferred. Satellite, cellular, or microwave connections may only be used with prior approval. Employees in California, Illinois, Montana, or South Dakota will receive a bi-weekly stipend for internet expenses. Humana will provide essential phone and computer equipment for the role. Please work from a dedicated space free of distractions to ensure the protection of member PHI and HIPAA compliance. Interview Process: We will utilize innovative interview technology, HireVue, to streamline our hiring process and connect with you effectively. Travel Requirements: Occasional travel to Humana offices for training or meetings may be necessary despite this being a remote position. Weekly Hours: 40 Compensation: The estimated salary range for this full-time position is $59,300 - $80,900 per year, depending on location and qualifications. This role is eligible for a bonus incentive plan based on both company and individual performance. Benefits: Humana provides extensive benefits that support overall well-being, including medical, dental, and vision coverage, retirement plans, generous paid time off policies, disability insurance, and more. Application Deadline: 02-12-2026 About Humana: Humana Inc. (NYSE: HUM) is committed to prioritizing health and well-being for our teams, customers, and communities. Our all-inclusive insurance and healthcare services empower millions to achieve optimal health outcomes. Equal Opportunity Employer: Humana promotes a workplace free from discrimination, providing equal opportunities for all applicants and employees based on valid job requirements without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status.
