Telephonic RN Care Manager

Profile

Description

The RN Care Manager 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 well-being 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 use of assessment, data, conversations with member, 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.

Required Qualifications

Bachelor's degree

3 - 5 years of clinical acute care experience

Licensed Registered Nurse (RN) with no disciplinary action and ability to apply for Illinois license

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.

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

Preferred Qualifications

Bi-Lingual (English/Spanish)

Previous Humana at Home systems experience

Certified Case Manager (CCM)

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

Managed care experience

Prior experience with Medicare & Medicaid recipients

Previous experience with electronic case note documentation and experienced with documenting in multiple computer applications/systems

Experience with health promotion, coaching and wellness

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

Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.

Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M

Additional Information

Work at Home - Nationwide

Our Hiring Process

We may contact you via text message and email to gather more information once we review your application. We use a software platform called Modern Hire. Modern Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

Language Proficiency Testing

Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Scheduled Weekly Hours

40

Company info

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