Humana

About Humana

 

Job Category:

Integrated Care & Care Operations - Care Management

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full Time

RN Case Manager - Telephonic Nurse 2 - (Remote)

Humana - Work At Home, Florida

Posted: 11/11/2018

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.

Job Overview

Humana At Home is a division of Humana that is dedicated to helping adults remain independent in their homes. Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition.  We contact members with chronic conditions by phone to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence.   All of our RN Care Managers telecommute, working from a dedicated home office space.

Click here for a "day in the life" preview of the Care Manager position

  • Telephonically assess Medicare, Medicaid, Commercial, and/or and Group Account members in seven domains of functioning
  • Evaluate member needs and requirements to achieve and/or maintain optimal wellness state
  • Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
  • Assess member’s physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, employing a variety of strategies/techniques to manage appropriately and provide timely intervention   

               

Required Qualifications

  • Active Registered Nurse (R.N.) license and possess the ability to be licensed as a registered nurse in multiple states without restrictions
  • Seasoned professional nurse with 3+ years of clinical nursing experience
  • Demonstrated clinical knowledge and experience with an adult chronic conditions
  • Intermediate to advanced computer skills and experience with Microsoft Word and Excel
  • Capacity to multi-task including use of multiple computer applications simultaneously
  • Effective communication and interpersonal skills
  • Effective problem solving and appropriate application of clinical knowledge
  • Proficient typing and computer navigation skills
  • Must have a separate room with a locked door that can be used as a home office to ensure you and your patients 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
  • Able to work 40 hours per week between the hours of 8am- 8pm with occasional Saturdays
  • Able to accommodate Eastern Time Zone work hours for two weeks of virtual training
  • Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10-panel drug test

Preferred Qualifications

  • Bachelor’s (BSN) or Master’s (MSN) degree in nursing
  • Previous managed care experience
  • Basic knowledge of complex care management and care management principles
  • Experience with motivational interviewing
  • Experience with behavior change, health promotion, coaching and wellness
  • Bilingual English/Spanish or Creole.  Must be able to speak, read and write in both languages without limitations or assistance.  See Additional Information on testing

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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