Care Management Network Analyst (Master's Level Social Worker)

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being.

Senior Bridge Care Management is seeking passionate, case management professionals and leaders dedicated to delivering the highest quality in-home care management programs to complex chronically ill patients nationwide.

As a Care Management Network Analyst you will provide oversight to the care management services according to the established plan of care. As a Care Management Network Analyst you will provide a multidisciplinary approach to care. The Care Management Network Analyst position includes the following: * Assigning assessments to identify problems, eligibility for assistance and need for services * Ensuring care management services are in accordance with each client's contractual program requirements and is high quality and complies with company -adopted evidence- based clinical practice guidelines * Reviewing a professional care plan from the assessment findings to ensure the facilitation of the provision of the best possible care * Enter Practice and Care Manager information into Rosalind, follow up on incorrect or missing data * Verify Member licenses and follow up to attain all supporting documentation * Compliance for CMN Members, including licensures and insurance * Update and maintain CMN database * Send paperwork and program material to CMN members * Create and send ID cards to CMN Members * Recruitment of CMN Members * Thorough and timely documentation of initial and ongoing assessments and outcomes * Communicate explanation of the care plan and all subsequent cost of all services to client and or families, Attorney or Guardians * Act as a liaison to families as well as with collateral clinicians, professionals & agencies. * Effectively communicate with clients, families, Physicians, Attorneys, etc. and all members of the multidisciplinary team all findings, outcomes, plans that relate to the provision of client care * Work effectively with all departments to ensure the best delivery of service * Participate in case conferences with other disciplines providing care * Observes infection control practices and uses standard precautions * Participates in quality management/performance improvement activities * Performs any other duties as requested by the company **Key Competencies** * Builds Trust: Walks the talk; makes choices that are consistent with Humana’s ethical principles; is emotionally intelligent; manages self and relationships effectively, through self-awareness, self-management, awareness of others and skill in dealing with others. * Implementation / Execution: Effectively leverages available resources (financial, people, time) to accomplish objectives and maximize return on investment. Makes appropriate decisions in the face of ambiguity. Anticipates and resolves barriers and constraints. Organizes and manages multiple priorities and/or projects using appropriate methodologies and tools. * Innovates: Introduces or develops new ideas and processes which improve performance and productivity. Generates insights through thought leadership. Leverages business intelligence, data, insights, and other research to drive differential value and expand Humana’s capability to compete. * Problem Solving: Proactively identifies, evaluates, and solves problems with rigorous logic and a systematic approach; looks beyond the obvious to see root cause issues and creative solutions.

**Role Essentials** * Master’s Degree in Social Work (MSW) * At least one year of work experience in field based eldercare, homecare, and/or care management environment * Effective time management and communication skills * Proficient with Microsoft applications: Outlook, Word, Excel, and PowerPoint **Role Desirables** * Care management experience * Enthusiastic, positive thinker with effective organization and communication skills * Ability to work in a multi-disciplinary team * Experience/contacts with community based organizations * Care Management Certification