[Hiring] 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.

• Employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.
• Identifies and resolves barriers that hinder effective care.
• Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessment, data, conversations with members, and active care planning.
• Must be able to navigate multiple systems and use critical thinking skills.
• Understands 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.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Follows established guidelines/procedures.

The working hours for this position are between 8:00am-7:00pm central standard time; but core hours are primarily 8:00am-5:00pm central standard time. This position will 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 experience of clinical acute care experience
• Licensed Registered Nurse (RN) in the state of Illinois with no disciplinary action
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Requirements

• Experience with case management, discharge planning, and patient education for adult acute care (Preferred)
• Managed care experience (Preferred)
• Certified Case Manager (CCM) (Preferred)
• Bi-Lingual (English/Spanish) (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.
• 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.

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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.