Bilingual RN Care Manager

Humana

20d • Remote

About The Position

Become a part of our caring community and help us put health first This is a remote, telephonic position, but you must live in Puerto Rico. The RN Care Manager uses clinical knowledge to assess and evaluate members' needs to achieve and maintain optimal wellness. They also guide members with chronic conditions toward and facilitate interaction with resources appropriate for their care and wellbeing. The Care Manager reports to a Manager of Care Management, and work assignments frequently require interpretation and independent determination of the appropriate courses of action. We require you to be bilingual in English/Spanish and will test you for both languages - Speaking/Reading/Writing included. Please submit your resume in English. The Care Manager, Telephonic Nurse employs a variety of strategies and techniques to manage a member's physical, environmental and psycho-social health issues.

Requirements

• Bachelor's Degree in Nursing (BSN)
• Bilingual in English and Spanish (and able to pass language proficiency tests in both languages)
• Active RN license without restrictions in Puerto Rico
• Active RN license without restrictions in Florida or licensure in another state and a passing score on the NCLEX exam.
• Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico).
• Prior clinical experience in adult acute care, skilled nursing, rehabilitation or discharge planning
• Knowledge in Chronic Condition management (treatment, pharmacological treatment, signs and symptoms), including Diabetes, Hypertension, COPD, and chronic kidney disease.
• Shift is 8-hours, plus 1 hour for lunch, from 8:30 AM to 5:30 PM EST and we adjust for Daylight Savings. We adjust the work schedule according to business needs including necessary overtime and weekends.
• To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can only be used if leadership approves it.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Health Plan experience
• Previous Case Management Experience
• Call center or triage experience
• Previous experience managing Medicare members

Responsibilities

• Resolve barriers that hinder care.
• Ensure patient is progressing towards desired outcomes by managing patient care through assessments and evaluations.
• May create member care plans.
• Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.
• Require minimal direction and receive guidance where needed.
• Follow established guidelines/procedures.
• Use your skills to make an impact

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees