Care Manager, Telephonic Nurse
About The Position
The Care Manager, Telephonic Nurse 2 assesses and evaluates members’ needs in a telephonic environment, helping members and their families achieve or maintain optimal wellness by connecting them with appropriate care and support resources. The role uses varied strategies to manage members’ physical, environmental, and psychosocial health issues, identify and resolve barriers to effective care, and monitor progress toward desired outcomes through assessments, data, conversations, and active care planning. The position requires navigating multiple systems and applying critical thinking, independent judgment, and established professional standards and procedures. The nurse works by phone with an assigned member population, conducting health assessments, developing care plans, and educating members about chronic conditions and gaps in their health care plans. Working hours fall between 8:00 a.m. and 7:00 p.m. Central Time, with core hours primarily from 8:00 a.m. to 5:00 p.m. The role is remote, with occasional travel to Humana offices for training or meetings. Home-based employees must have internet service with at least 25 Mbps download and 10 Mbps upload speeds and a dedicated workspace that protects member PHI/HIPAA information.
Requirements
- Bachelor’s degree.
- At least 3 years of clinical acute care experience.
- Active Registered Nurse (RN) license in Illinois with no disciplinary action.
- Comprehensive knowledge of Microsoft Office applications, including Word, Excel, and Outlook.
- Passion for contributing to an organization focused on continuously improving consumer experiences.
- For home-based work, internet service with at least 25 Mbps download and 10 Mbps upload speeds.
- For home-based work, a dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information.
Nice To Haves
- Experience with case management, discharge planning, and patient education for adult acute care.
- Managed care experience.
- Certified Case Manager (CCM).
- Bilingual English/Spanish.
Responsibilities
- Assess and evaluate members’ needs and requirements to support optimal wellness.
- Guide members and families toward appropriate resources and facilitate their interaction with those resources.
- Manage members’ physical, environmental, and psychosocial health issues using a variety of strategies and techniques.
- Identify and resolve barriers that hinder effective care.
- Monitor patient care and progress toward desired outcomes using assessments, data, conversations with members, and active care planning.
- Navigate multiple systems and apply critical thinking.
- Conduct health assessments, develop care plans, and educate assigned members by phone about chronic conditions and gaps in their health care plans.
- Follow established guidelines and procedures, using independent judgment as appropriate.
Benefits
- Medical benefits.
- Dental benefits.
- Vision benefits.
- 401(k) retirement savings plan.
- Paid time off, company holidays, and personal holidays.
- Paid parental and caregiver leave.
- Short-term disability.
- Long-term disability.
- Life insurance.
- Bonus incentive plan based on company and/or individual performance.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
