[Hiring] Care Manager, Registered Nurse - Transition of Care, Physical Health @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 after a hospitalization. The Care Manager guides members/families toward and facilitates 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.
• You will report to a Manager Care Management.
• The Care Manager employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.
• Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.
• Call member's post discharge to assess needs, review discharge summary, and educate on disease progression.
• Follow up with them for 30 days.
• Maintain relationships with community hospitals and facilities to assist with post discharge planning needs.

Qualifications

• Must reside in the state of South Carolina.
• 3 or more years of clinical acute care experience.
• Licensed Registered Nurse (RN) in the state of South Carolina with no disciplinary action.
• Experience with case management, discharge planning, transition of care, and/or patient education for adult acute care.
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook.

Requirements

• Bachelor's degree (preferred).
• Knowledge of Milliman or Interqual (preferred).
• Managed care experience (preferred).
• Certified Case Manager (CCM) (preferred).
• Work at Home Requirements:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps required; wireless, wired cable, or DSL connection suggested.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.

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, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance and many other opportunities.

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.

$71,100 - $97,800 per year. This job is eligible for a bonus incentive plan based upon company and/or individual performance.