Become a part of our caring community and help us put health first

The Behavioral Health Strategy Lead (Behavioral Health PIHP Liaison) shall have responsibility for coordinating and bridging gaps between the Health Plan and the identified Prepaid Inpatient Health Plans (PIHPs). This position will support day-to-day operations as a subject matter expert for the Humana market team for internal behavioral health functions. This role will be the primary contact representing Humana’s HIDE SNP Plus total population with the PIHPs.

• Participates in the interdisciplinary care team as outlined in the agreements between PIHPs and Humana.
• Supports day-to-day operations as a subject matter expert for Humana Behavioral Health market teams.
• Assesses and interprets customer needs and requirements.
• Manages internal and external behavioral health concerns/cases to resolutions that are pertaining to the PIHPs.
• Ensures compliance with accreditation standards, contract, and Center for Medicare and Medicaid Services (CMS) requirements.
• Works closely with the Quality partners including but not limited to Performance/Quality Improvement Coordinator, Behavioral Health Network Director, Quality Management Coordinator, and Behavioral Health Quality Management Coordinator to ensure quality requirements and targets are adhered to throughout the Behavioral Health delivery system.
• Regularly reviews integration performance, network adequacy, performance improvement projects, and surveys related to integration.
• Assists the Community Engagement and Provider Relations teams in providing a Behavioral Health perspective for meetings and events with community organizations, provider groups, and advisory councils.
• Participates in the Interdisciplinary Care Team (ICT)meetings as key participant.
• Collaborates and monitors referral tracking and service access metrics with Humana enterprise, PIHP or other key partners related to Behavioral Health care delivery.
• Establishes and maintains a listing of key contract personnel at each coordinating PIHP and ensure that each coordinating PIHP is aware of Humana’s personnel for ongoing Humana-PIHP communication and coordination.
• Key participant in Joint Operating Committees, biweekly to monthly case reviews, ICTs, and ad-hoc rounds related to Behavioral Health care delivery.

Use your skills to make an impact

Required Qualifications:

• Must reside in Michigan, Illinois, Indiana, Ohio or Wisconsin
• Licensed Mental Health Professional with one (1) of the following active, unrestricted licenses in the state of Michigan: Licensed Master Social Worker or Licensed Clinical Social Worker (LMSW/LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Addiction Counselor (LAC).
• Minimum three (3) years of behavioral health experience.
• Intermediate to advance proficiency in Microsoft Office programs specifically, Outlook, PowerPoint, Word and Excel.
• Demonstrated ability to run large scale, highly visible programs with responsibility for multiple teams.
• Experience in problem solving and consultation within complex environments.
• Strong influencing and process improvement skills.
• Ability to communicate effectively and deliver presentations to senior leaders.

Preferred Qualifications

• Residency in the state of Michigan.
• High-level administrative experience with navigating and/or overseeing state’s safety net behavioral health programs and services through the infrastructure of state-designated local behavioral health authorities.
• Knowledge of community resources and behavioral health practices with high-risk populations.

Additional Information

• Workstyle: This is a remote position.
• Travel: Up to 25% travel to Michigan Department of Health and Human Services (MDHSS), locations across Michigan, including participation in team engagement meetings and conferences both within and outside the state.
• Direct Reports: Up to 5 associates.

WAH Internet Statement

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 required; 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.

Interview Format

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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.

$115,200 - $158,400 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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

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.

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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.