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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Telephonic Case Manager (Medicare) - VA, NC, MD

Humana - Work At Home, Virginia

Posted: 08/22/2018

Description

The Case 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 wellbeing of members, work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The hours of this role are Mon -Fri, 8am-5pm, and will focus on Medicare members in the region of VA, NC & MD.

The Case Manager 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 (without restrictions) in the state you will be working.
  • Ability to be licensed in multiple states without restrictions
  • Prior clinical experience in an acute care, skilled or rehabilitation clinical setting
  • Experience with discharge planning and patient education for adult acute and skilled care
  • Excellent computer skills and ability to easily navigate multiple applications
  • Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M

Preferred Qualifications

  • Experience with case management
  • Knowledge of Milliman or Interqual
  • Managed care experience
  • Certified Case Manager (CCM)

Additional Information

As part of our hiring process for this opportunity, we will be using a technology called Montage Voice which allows us to quickly connect and gain valuable information from you about your relevant experience.

 

If you are selected for a phone screen you will receive an email inviting you to participate in a Montage Voice interview. During this call you will be asked a set of questions pertaining to this particular role and you will provide recorded responses. The entire process takes about 15-20 minutes and can be done at your convenience. Your responses will be reviewed and you will be informed if you were selected for an in person or video interview, depending on your location.

Scheduled Weekly Hours

40

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