Care Manager, Telephonic Nurse

Humana•Work at Home - Oklahoma, OK

5d•$71,100 - $97,800•Remote

About The Position

The Care Manager, Telephonic Nurse is an Oklahoma-based remote role focused on enrollees with primary physical health diagnoses. The care manager assesses and evaluates enrollees’ needs, develops care plans, and guides enrollees and families toward appropriate care and community resources to help achieve or maintain optimal wellness. The role requires clinical interpretation and independent determination of appropriate actions, and may include home- or facility-based visits when needed to support enrollee engagement and services. The position works collaboratively with an interdisciplinary care management team that includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. The care manager uses clinical expertise to decide when face-to-face support is needed and coordinates appropriate team involvement or in-person meetings with enrollees. The role is remote, with occasional travel to Humana’s Oklahoma office or other Humana offices for meetings and training. The position is scheduled for 40 hours per week. The stated annual base pay range is $71,100–$97,800, with eligibility for a bonus incentive plan based on company and/or individual performance. Humana offers medical, dental, and vision benefits; a 401(k) retirement savings plan; paid time off and holidays; paid parental and caregiver leave; short- and long-term disability; life insurance; and other benefits. Home or hybrid employees must maintain internet service with at least 25 Mbps download and 10 Mbps upload speeds and work from a dedicated space that protects member PHI/HIPAA information.

Requirements

Must reside in Oklahoma.
Active Registered Nurse (RN) license, Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW).
At least 1 year of clinical experience.
At least 2 years of care management experience.
Experience working with Medicaid and/or Medicare enrollees to coordinate services, care needs, or benefits.
Knowledge of community health and social service agencies and other community resources.
Comprehensive knowledge of Microsoft Office applications, including Word, Excel, and PowerPoint.
For home or hybrid work, internet service must provide at least 25 Mbps download and 10 Mbps upload speeds.
For home or hybrid work, ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information.

Nice To Haves

Case Management Certification.
Bilingual Spanish-speaking ability.

Responsibilities

Assess and evaluate enrollees’ needs and requirements to help achieve or maintain optimal wellness.
Guide enrollees and families toward appropriate care, wellbeing, and community resources.
Use strategies and techniques to manage enrollees’ behavioral, physical, environmental, and psychosocial health needs.
Continuously monitor assessments, evaluations, and care to determine whether enrollees are progressing toward desired outcomes.
Identify and resolve barriers that hinder effective care.
Create enrollee care plans and understand how department, segment, and organizational objectives link to related areas.
Perform telephonic and face-to-face assessments and evaluations.
Collaborate with providers and community services to promote quality and cost-effective outcomes.
Determine when face-to-face enrollee support is required and engage appropriate care management team members or coordinate in-person meetings.
Follow established guidelines and procedures.
Travel to Humana offices for occasional meetings and training, as required.