Bilingual RN Care Manager - Remote, nationwide

Humana

3d • $71,100 - $97,800 • Remote

About The Position

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. 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 times 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.

Requirements

• Active Registered Nurse (R.N.) license with no disciplinary action.
• Hold an active Compact nursing license and reside in the state that holds your compact license.
• Must be bilingual in Spanish and English - resume must be submitted in English
• Oral and written fluency in Spanish and English - ability to pass a language test will be required.
• Minimum education of an Associates degree in Nursing.
• Minimum of 3 years of clinical RN experience.
• Experience using clinical knowledge to manage various adult chronic conditions, including development and implementation of individualized care planning.
• Proficient computer skills with ability to quickly learn and navigate multiple systems, utilizing dual computer monitors.
• Experience with Microsoft and Excel
• Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues.
• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
• Effective telephonic and virtual communication skills.
• 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.

Nice To Haves

• BSN or MSN degree in nursing or equivalent
• Previous adult chronic conditions care management
• Previous experience in care management including 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)

Responsibilities

• 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
• Use your skills to make an impact

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• many other opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree