Care Manager, Telephonic RN

Humana

1d • Remote

About The Position

Become a part of our caring community and help us put health first The Compact licensed telephonic Care Manager works from home in a call center environment. They assess and evaluate members' needs and requirements to achieve or maintain optimal wellness by providing care coordination and facilitating member or family interaction with resources appropriate for the care and wellbeing of the member. Job Description Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management services are centered on the person rather than the condition. The Care Manager uses a range of strategies and techniques to manage a member's physical, environmental, and psycho-social health issues. They identify and resolve barriers to effective care and continuously monitor progress through assessments and evaluations to ensure members achieve their desired health outcomes. Role Overview The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. This role operates in a fast-paced environment, requiring the ability to quickly engage with members while navigating multiple computer applications simultaneously. To maintain compliance and support the auto-dialer process critical to our operations, care managers follow structured daily schedules, which limits day-to-day flexibility. All our RN Care Managers are work at home associates, working from a dedicated home office space (see Work at Home Guidance below). Remote Care Managers are expected to achieve established outcomes, quality, and productivity benchmarks and demonstrate advanced communication and interpersonal skills. Duties Include Telephonically working with Medicare members with transitional needs and complex chronic conditions. Assessing members’ physical, environmental, and psychosocial health needs, collaborating with a multidisciplinary team, and implementing timely clinical interventions to manage risks, coordinate care, and help prevent avoidable hospitalizations. Collaboration with members who face multiple chronic conditions, along with financial and functional challenges, to support them in achieving and sustaining optimal health. May develop individualized member care plans. Success in this position requires that you Understand department, segment, and organizational strategies and objectives, and how they connect to related areas. Exercise judgement regarding own work methods, even in ambiguous situations, with minimal direction and occasional guidance where needed. Demonstrate flexibility and ability to promptly adapt to new processes and workflows. Adhere to established guidelines/procedures. Use your skills to make an impact

Requirements

• Active Registered Nurse (R.N.) license with no disciplinary action on any license.
• Must hold an active Compact nursing license and reside in the state that holds your compact license.
• 3+ years of clinical acute care experience with case management, discharge planning, and patient education for adult acute care
• Demonstrated clinical expertise in managing chronic conditions through individualized care planning, supported by strong assessment and critical thinking skills
• Proficiency in Microsoft Office applications including Word, Excel, and Outlook.
• Demonstrated proficiency in navigating multiple systems using dual monitors, with strong computer skills and the ability to quickly learn new applications.
• Skilled in autonomous decision-making, troubleshooting, and problem-solving system-related issues

Nice To Haves

• BSN or MSN degree
• Case Management experience
• Managed care experience
• Certified Case Manager (CCM)
• Bilingual in English and Spanish (see Language Proficiency Testing below)

Responsibilities

• Telephonically working with Medicare members with transitional needs and complex chronic conditions.
• Assessing members’ physical, environmental, and psychosocial health needs, collaborating with a multidisciplinary team, and implementing timely clinical interventions to manage risks, coordinate care, and help prevent avoidable hospitalizations.
• Collaboration with members who face multiple chronic conditions, along with financial and functional challenges, to support them in achieving and sustaining optimal health.
• May develop individualized member care plans.
• Understand department, segment, and organizational strategies and objectives, and how they connect to related areas.
• Exercise judgement regarding own work methods, even in ambiguous situations, with minimal direction and occasional guidance where needed.
• Demonstrate flexibility and ability to promptly adapt to new processes and workflows.
• Adhere to established guidelines/procedures.

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