About Humana


Job Category:

Integrated Care & Care Operations - Care Management


United States

Approximate Salary:

Not Specified

Position Type:

Full time

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RN - Care Manager, Telephocic Nurse 2 (HMS - Fully Bilingual, Clinical exp a MUST) - San Juan, PR

Humana - San Juan Rico, United States

Posted: 08/3/2018


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.


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

  • Registered Nurse from an accredited institution who have actively practiced nursing in a state, jurisdiction or territory of the US for 2 of the preceding 3 years without having license acted against by the licensing authority of any jurisdiction
  • Active RN license without restrictions in Puerto Rico and/or Active RN license in Florida, USA.
  • Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico) IF you have an Active RN license in FL, USA, this is not a mandatory requirement
  • Prior clinical experience in an acute care, skilled nursing, rehabilitation, OR discharge planning
  • If you do not have an active FL RN license:
    • You need to have 2 consecutive years of experience as RN of the preceding 3 years(no gaps in employment) and apply for FL RN license endorsement as soon as employment offer is accepted. OR,
    • If you have under 2 yrs. experience as RN and have attended to one of the accredited schools in PR, must successfully complete and pass the NCLEX exam within 60 days of employment
  • Ability to work independently under minimum supervision and with a team
  • Able to work 8:00 AM  - 6:00 PM (Adjust work schedule according to business hours, overtime and/or weekends)

Preferred Qualifications

  • Health Plan experience
  • Previous Case Management Experience
  • Call center or triage experience
  • Previous experience managing Medicare members

Additional Information

Additional Information***Please submit resume in EnglishLanguage Proficiency TestingAny Humana associate who speaks with a member in a language other than Spanish 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.Humana Perks: 
  • Full time associates enjoy competitive pay and a comprehensive benefits package that includes:
  • Two types of Medical plans with pharmacy coverage
  • Dental, Vision & Life Insurance offered
  • 401 k Retirement Savings Plan offered after 45 days of employment.
  • Spouse / partner coverage
  • Paid time off & Paid Holidays
  • Well-being programs where you can earn additional money, gift cards, or prizes for healthy behavior and wellness activities.
  • Volunteer Day Off
  • Education reimbursement and/or scholarships for qualifying dependent children 
  • Parental leave include maternity, paternity and child adoption leave

Scheduled Weekly Hours


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