RN Telephonic Care Manager
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Job Description
Telephonic RN Care Manager at Humana, a U.S. healthcare and insurance company. Assessing member needs, coordinating care, and developing measurable chronic-care plans remotely.
Responsibilities:
- Telephonically assess Medicare, Medicaid, and/or Group Account members
- Create actionable and measurable care plans and track members' progress toward goals
- Use nursing judgment to assess and coordinate care for acute situations, including APS and EMS
- Discuss transitions of care and assist with safe discharge to the home
- Coordinate care for DME, home health, provider appointments, and related services
- Guide members and families toward appropriate care and wellbeing resources
- Assess members' physical, environmental, and psycho-social health issues
- Collaborate with a multidisciplinary team including social workers, dietitians, and pharmacists
- Provide timely interventions using varied care-management strategies and techniques
- Conduct telephonic outreach through an auto dialer system
- Meet daily quality and productivity measures
- Navigate multiple computer applications while engaging with members
Requirements:
- Active Registered Nurse (RN) Multi-State/Compact State license with no disciplinary action
- 3 or more years of clinical nursing experience
- Proficient in Microsoft Office Word, Excel, and Outlook
- Ability to quickly learn and navigate new applications
- Effective communication and interpersonal skills
- Work from a dedicated home office space
- Maintain working home internet at all times
- Minimum internet speed of 25 Mbps download and 10 Mbps upload
- Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- Bachelor's degree in nursing (BSN) preferred
- Previous experience with adult chronic conditions or care management preferred
- Case Management certification (CCM) preferred
- Bilingual in English and Spanish preferred
- Ability to work Monday-Friday 9:00am-5:30pm EST after training
- No time off permitted during the first month of training
Benefits:
- Bonus incentive plan based upon company and/or individual performance
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Personal wellness support
- Smart healthcare decision support
- Remote work from home
- Occasional travel to Humana offices for training or meetings
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