Job Details

RN Case Manager - Telephonic Nurse 2 - Complex Case Management Program Remote

Location
Boston, MA, United States

Posted on
Feb 25, 2022

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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

Humana is seeking a Telephonic Care Manager for our Complex Case Management Program. The Care 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. In this role you will:


Apply your clinical knowledge to educate and empower your members, to take charge of their own healthcare decisions.
Provide guidance and clinical expertise on how to navigate through the health care setting.
Provide ongoing consultation with your patients via telephone to ensure that they are receiving the best quality of care possible.
Consult with your patients on how to ask the right questions and interpret complex medical content in an effort to enhance the member experience.
Coordinate community care and services as deemed appropriate.
Understand clinical program design, implementation, and management, monitoring and reporting.
Comply with performance and reporting standards as defined by Humana.
Training will be virtual
Travel may be up to 5%


Required Qualifications


Active RN (Registered Nurse) license in the state(s) required to practice with no disciplinary action.
Must be licensed in an eNLC state (multi-state license)
Ability to be licensed as a registered nurse in multiple states without restrictions.
3 - 5 years of clinical acute care experience
Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
Exceptional communication and interpersonal skills.
Ability to work independently under general instructions and with a team.
Strong computer, web navigation and research skills.
Ability to learn how to use virtual information systems (example would be WebMD)
Must have a separate room with a locked door that can be used as a home office to ensure you and your patient has absolute and continuous privacy while you work.
Must have accessibility to high speed DSL or cable modem for a home office. Please note Satellite internet cannot be used for this role. Internet speeds must be at a minimum of 10Mbps Download by 1Mbps Upload for Cable Broadband
Ability to work a full-time (40 hrs minimum) work schedule with availability to work between the hours of 8:30 a.m. and 5:00 p.m.


Preferred Qualifications


Bachelors degree in Nursing (B.S.N)
Highly desired clinician with both physical and behavioral health background
Bilingual in Spanish is highly desired
Prior Managed Care experience
Call center or telephonic triage experience
Experience with case management, discharge planning and patient education for adult acute care
Certified Case Manager (CCM)


Additional Information

Interview Format:

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected, you will receive correspondence inviting you to participate in a Modern Hire assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 15 - 20 minutes. Your answers will be reviewed and you will subsequently be informed if you will be moving forward to next round.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from **** with instructions to add the information into the application at Humana's secure website.

Scheduled Weekly Hours

40

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