[Hiring] Bilingual Care Manager, Telephonic Nurse @Humana

Role Description

Become a part of our caring community. The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and wellbeing of members.

• The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
• Employ a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.
• Identify and resolve barriers that hinder effective care.
• Ensure patients are progressing towards desired outcomes by monitoring patient care through assessment, data, conversations with members, and active care planning.
• Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.
• Working hours are between 8:00am-7:00pm central standard time; core hours are primarily 8:00am-5:00pm central standard time.
• Work with an assigned member population over the phone performing health assessments, care planning, and education on chronic conditions and any gaps in their health care plans.

Qualifications

• Bachelor's degree
• 3+ years of clinical acute care experience as a Licensed Registered Nurse
• Licensed Registered Nurse (RN) in the appropriate state with no disciplinary action with the ability to obtain Licensure in Illinois
• Must be bilingual in Spanish and English; resume must be submitted in English
• Oral and written fluency in Spanish and English – ability to pass a language test will be required
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
• Must be passionate about contributing to an organization focused on continuously improving consumer experience

Requirements

• Experience with case management, discharge planning, and patient education for adult acute care
• Prior experience with Medicare & Medicaid recipients
• Managed care experience
• Certified Case Manager (CCM)
• Previous experience with electronic case notes documentation and experienced with documenting in multiple computer applications/systems
• Experience with health promotion, coaching, and wellness
• Knowledge of community health and social service agencies and additional community resources
• Master's Degree

Benefits

• Competitive benefits that support whole-person well-being
• 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
• Many other opportunities

Additional Information

• Workstyle: Remote, work from home.
• Work Location: Illinois residency preferred.
• Typical workdays/hours: Monday – Friday, 8:00am – 5:00pm CST, occasional flexibility in scheduling may be required to accommodate member needs.
• Language Proficiency Testing: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment.
• WAH Internet: Minimum download speed of 25 Mbps and upload speed of 10 Mbps required; wireless, wired cable or DSL connection suggested.
• Employees who live and work from Home in specific states 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 business requirements.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• HireVue: We will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.
• Scheduled Weekly Hours: 40
• Pay Range: $71,100 - $97,800 per year, eligible for a bonus incentive plan based on performance.