RN-Care Manager Behavioral Health-RN in an eNLC state required-Remote Opportunity

Profile

Description

The Care Manager, Telephonic Behavioral Health 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 Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

Humana is seeking a Care Manager, Telephonic Behavioral Health 2 to telephonically assess, evaluate, and support members who are challenged by both mental illness and complex medical situations. Our goal is to provide support for both mind and body to allow each member to achieve and/or maintain their optimal health.

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. You will guide members and their families toward and facilitate interaction with resources appropriate for their care and wellbeing. You will work in collaboration with a multi-disciplinary team, employing a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Consult with your patients on how to ask the right questions and interpret complex medical/behavioral health 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.

Other responsibilities include:

Proactive telephonic outreach to eligible Humana members and engage participation in appropriate care management programs

Complete physical, psychological, emotional and environmental assessments, for the purpose of providing appropriate, timely interventions to ensure provision of optimal care

Develop plan of care with your member based on identified needs and recommend and/or coordinate interventions that may include information, education, resources and referrals

Coordinate community care and services as deemed appropriate

Work collaboratively with other members of the Interdisciplinary team - to include; LAL, IHWA, Social Services, Pharmacists, Psychiatrists, Utilization Management teams, Community Health Educators, EAP and others if appropriate

Comply with performance and reporting standards as defined by Humana Corporation

Utilize Motivational Interviewing and Solution-Oriented approaches in communication with members

Adhere to compliance standards, state and federal regulations and individual licensing boards

Participate in professional development activities

Additional responsibilities as deemed appropriate by Humana leadership

Required to become CCM certified within 2 years of date of hire

Required Qualifications

Registered Nurse in an eNLC state

Required to become CCM certified within 2 years of date of hire

Bachelor's degree in Nursing (B.S.N.) and/or Master's degree

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

4 years or more in an acute care setting of clinical nursing experience which includes at least 2 years in an integrated care setting managing members with both Medical and Behavioral Health needs

Experience with substance abuse treatment

Ability to interact effectively with multi-disciplinary team members in virtual environment

A separate room with a locked door that can be used as a home office to ensure you and your patients has absolute and continuous privacy while you work

Intermediate to advanced computer skills and experience with Microsoft Word and Excel

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

Excellent keyboard and web navigation skills

Exceptional communication and interpersonal skills with the ability to quickly build rapport

Ability to conceptualize and present clinical cases in concise and clear manner

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Ability to work a minimum of 40 hours per week between the hours of 8:30 am EST- 8pm EST (at least 1 day a week until 8 PM)

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

Experience working with the pediatric/adolescent population

Knowledge of community health and social service agencies and additional community resources

Managed care experience

Certified Case Manager (CCM)

Additional Information

Ability to work a minimum of 40 hours per week between the hours of 8:30 am EST- 8pm EST (at least 1 day a week until 8 PM)

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.

Scheduled Weekly Hours

40

Company info

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