Humana

About Humana

 

Job Category:

Integrated Care & Care Operations - Care Management

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full Time

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Care Manager, Telephonic Nurse

Humana - Work At Home, New York

Posted: 09/13/2018

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

  • Active RN license in the state(s) in which the nurse is required to practice
  • Ability to be licensed in multiple states without restrictions
  • Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
  • Proficient with Microsoft Word, Outlook and Excel
  • Ability to work independently under general instructions and with a team
  • Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

Preferred Qualifications

  • Education: BSN or Bachelor’s degree in a related field
  • Health Plan experience
  • Previous Medicare/Medicaid Experience a plus
  • Call center or triage experience
  • Previous experience in utilization management, discharge planning and/or home health or rehab
  • Bilingual is a plus

Scheduled Weekly Hours

40

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