Care Manager Telephonic Nurse Bilingual English/Spanish- Work at Home

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

The Care Manager, Telephonic Nurse 2 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.

Required Qualifications

Bachelor's degree

3-5 years of clinical acute care experience

Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action

Bilingual (English & Spanish)

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

Experience working in a production/metrics driven environment,

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

Preferred Qualifications

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

Knowledge of Milliman or Interqual

Managed care experience

Certified Case Manager (CCM)

Proficiency utilizing ScriptMed, Rx Nova, CRM (auto dialer program)

Additional Information

This is Work at Home role; however candidates must reside in a commutable distance to a specialty location in Ohio, Kentucky, Indiana, Arizona, Orlando or Miramar, FL

The standard operating hours are 8am-8pm EST (A set shift will be assigned within those hours, with 1 rotating late night a week & one scheduled holiday per year), Mandatory overtime is required

This role is not member facing

Scheduled Weekly Hours

40

Company info

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