[Hiring] Care Manager @Humana

Role Description

As a remote Telephonic Care Manager, you will report to a Manager of Care Management. You will provide a comprehensive, holistic approach for the complex Case Management (CM) program throughout the continuum of care.

• Provide case management specialized interventions by leveraging the most appropriate care sites and levels of care to prevent or decrease hospital readmissions.
• Promote appropriate utilization of alternative sources of available funding.
• Enhance coordination of care and reduce fragmentation of clinical services.
• Serve as the point of contact in the complex case management Program for the beneficiary for all activities within the clinical spectrum.
• Coordinate and collaborate within the Care Management programs, Military Treatment Facility (MTF) Utilization Management/Case Management/CM staff, physicians or providers to ensure a fully integrated care plan addressing all beneficiary needs and conditions.

Qualifications

• U.S. citizenship required for this position due to Department of Defense Contract.
• Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services).
• Active RN license in state of employment.
• Ability to obtain CCM certification within 1 year of hire.
• 2 years case management experience.
• 3 years clinical RN or managed care RN experience.

Requirements

• Work Style: Remote
• Work Schedule: Monday – Friday; must be able to work an 8-hour shift between the hours of 8:00 a.m. – 6 p.m. EST.
• Training: Mandatory for the first 4 weeks between the hours 8:00 a.m. – 5:00 p.m. EST.
• Work at Home Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps required; dedicated workspace free from interruptions to protect member PHI / HIPAA information.
• 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.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off including paid time off, company and personal holidays, paid parental and caregiver leave.
• Short-term and long-term disability.
• Life insurance and many other opportunities.