Care Manager, Telephonic Nurse 2

Humana•Work at Home - Oklahoma, OK

1d•$71,100 - $97,800•Remote

About The Position

The individual in this role will work as an Oklahoma-based, primarily telephonic care manager. This care manager will assess and evaluate enrollees' needs and requirements to achieve or maintain optimal wellness. The care manager will guide enrollees/families towards and facilitate interaction with appropriate resources for their care and wellbeing. The Care Manager, Telephonic Nurse 2 work assignments are varied but will focus on those enrollees with a primary physical health diagnosis. This role requires interpretation and independent determination of appropriate actions and may require home or facility-based visits to enhance enrollee engagement and services. You will work in collaboration with the interdisciplinary care management team. This team includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. We design this team-based approach to ensure enrollees receive holistic person-centered care management. The Care Manager, Telephonic Nurse 2 will utilize clinical expertise and experience to determine when face-to-face enrollee support is required. They will engage the appropriate members of the care management team and/or coordinate in-person meetings between the care manager and the enrollee.

Requirements

Must reside in Oklahoma.
Active Registered Nurse (RN) license, Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW)
Minimum 1-year clinical experience.
2 or more years of care management.
Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs or benefits.
Knowledge of community health and social service agencies and additional community resources.
Exceptional communication and interpersonal skills with the ability to quickly build rapport.
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint.

Nice To Haves

Case Management Certification (CMC).
Bilingual Spanish Speaking

Responsibilities

Employs a variety of strategies, approaches, and techniques to manage an Enrollee’s behavioral, physical, environmental, and psycho-social health needs.
Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations.
Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes.
Creates Enrollee care plans, and understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed.
Performs telephonic and face to face assessments and evaluations of the member’s needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member.
Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations.
Creates member care plans.
Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Collaborates with providers and community services to promote quality and cost-effective outcomes.
Follows established guidelines/procedures.
Possible travel to Humana Oklahoma office for meetings and training