Care Manager Telephonic Nurse - Remote Work from Home

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Job Information
Humana
Care Manager, Telephonic Nurse - Remote (Work from Home)
in
San Juan
Puerto Rico
Description
The Care Manager, Telephonic Nurse, 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 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Care Manager, Telephonic Nurse employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psychosocial 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.
Responsibilities
The Care Manager, Telephonic Nurse, 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 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Care Manager, Telephonic Nurse employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psychosocial 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 (Puerto Rico) 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
Bilingual English/ (other language[s]). Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing 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)
Active Nursing License for the state of Florida
Additional Information:
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

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