RN Case Manager - Telephonic Nurse 2 -Compact Licensure Required Remote

Profile

Description

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 facilitate 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.

Responsibilities

Humana is seeking a Telephonic Care Manager for our Complex Case Management Program. The Care Manager 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 assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. In this role you will:

Apply your clinical knowledge to educate and empower your members, to take charge of their own healthcare decisions.

Provide guidance and clinical expertise on how to navigate through the health care setting.

Provide ongoing consultation with your patients via telephone to ensure that they are receiving the best quality of care possible.

Consult with your patients on how to ask the right questions and interpret complex medical content in an effort to enhance the member experience.

Coordinate community care and services as deemed appropriate.

Understand clinical program design, implementation, and management, monitoring and reporting.

Comply with performance and reporting standards as defined by Humana.

Required Qualifications

Active RN (Registered Nurse) license in the state(s) required to practice with no disciplinary action.

Must be licensed and reside in an eNLC state

Certified Case Manager (CCM)

Ability to be licensed as a registered nurse in multiple states without restrictions.

3 - 5 years of clinical acute care experience

Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook

Exceptional communication and interpersonal skills.

Ability to work independently under general instructions and with a team.

Strong computer, web navigation and research skills.

Ability to learn how to use virtual information systems (example would be WebMD)

Ability to work a full-time (40 hrs. minimum) work schedule with availability to work between the hours of 8:30 a.m. and 5:00 p.m. Eastern Standard Time

Work-At-Home Requirements

WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

Bachelor's degree in Nursing (B.S.N)

Highly desired clinician with both physical and behavioral health background

Bilingual in Spanish is highly desired

Prior Managed Care experience

Call center or telephonic triage experience

Experience with case management, discharge planning and patient education for adult acute care

Additional Information

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Vaccination Policy

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com