Care Manager Telephonic Nurse 2/Medicaid RN - Bilingual English/Spanish - Orlando FL

Profile

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. Will 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

Licensed Registered Nurse (RN) in the state of Florida with no disciplinary action

3-5 years current or recent experience in adult population within acute care

2-3 years experience with care management, discharge planning and patient education

Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook

Comprehensive knowledge of Medicaid

Knowledge of Managed Care

Fully Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. If selected for the position, you will be required to take a Language Proficiency Assessment in English/Spanish. See Additional Information on testing

Preferred Qualifications

Certified Case Manager (CCM)

Additional Information

Schedule: Hours of Operation: Monday-Friday 8:30 am to 5:00 pm

Travel: Must be willing to commute about 10% to office or to meet with members (One time monthly on average)

Location: Must reside within 50 miles of Orlando, FL

Work at Home/Remote Requirements : Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information (Must have a separate room for privacy with a locked door during working hours and during communication with members)

Transportation Requirements: Valid driver's license, car insurance, and access to an automobile. This role is a part of Humana's Driver Safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

Screening Requirements:

This role is considered patient-facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be tested for TB.

Associate working in the State of Florida will need Completion of a Level II; AHCA background clearance Fingerprinting .

Training: 6-8 weeks in WAH office, virtually.

Language Proficiency Testing: Any Humana associate who speaks with a member in a language other than Spanish and/or 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

Company info

Humana Inc.
Website : http://www.humana.com