Become a part of our caring community and help us put health first

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.

Job Description

The first 4 weeks of training will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training. Following training, the start time is 9:00AM or 10:00AM EST.

Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We contact members with multiple chronic conditions as well as financial and functional barriers in order to assist them in achieving and maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence, while using a multidisciplinary team.

This position will be part of our Special Needs Program (SNP) team . All of our SNP RN Care Managers are work at home associates, working from a dedicated home office space. Work at home care managers are responsible for meeting quality and productivity measures daily and maintaining working home internet at all time with demonstrated advanced communication and interpersonal skills.

This is a very compliance driven and highly visible program at Humana. The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. Environment is fast paced and requires ability to engage quickly with member while concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility in care manager’s schedule.

Duties:

• Telephonically assess Medicare, Medicaid, and/or and Group Account members and create actionable and measurable care plans to help guide and track the members' progress toward goals

• Use nursing judgment to assess and coordinate care for acute situations (APS, EMS)

• Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc.

• 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, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention

Click here to learn about a "Day in the Life" of our remote RN Care Managers.

Day In The Life RN SNP Care Manager - YouTube (https://www.youtube.com/watch?v=0jjvY9dTpCg)

Use your skills to make an impact

Required Qualifications

• Active Registered Nurse (R.N.) license with no disciplinary action.

• Hold an active Compact nursing license - must have prior to applying for the role

• The National Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one license and the ability to practice in all the states that participate in the program. You must reside in the state that holds your compact license. License must be current with no disciplinary action.

• Minimum of an Associate's degree in nursing.

• Seasoned professional nurse with a minimum of 3 years of clinical nursing experience.

• Demonstrated clinical knowledge and expertise as evidenced by providing intervention to manage variety chronic conditions, including development and implementation of individualized care planning.

• Intermediate to advanced computer skills as evidenced by ability to navigate multiple systems, utilizing dual computer monitors.

• Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues.

• Experience with Microsoft and Excel.

• Proficient typing and computer navigation skills.

• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.

• Effective communication and interpersonal skills.

• Effective problem solving and appropriate application of clinical knowledge.

• Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.

• Must possess advanced telephonic and virtual communication skills.

Preferred Qualifications

• BSN or MSN degree in nursing or equivalent.

• Experience with adult chronic conditions.

• Experience in care management.

• Knowledge of complex care management and care management principles.

• Experience with motivational interviewing.

• Experience with MCG or CMS guidelines, assessment, and documentation practice.

• Case Management certification (CCM).

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$71,100 - $97,800 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 02-27-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.