Telephonic Care Manager RN- Women's Health
About The Position
The Women's Health Care Manager, Telephonic Nurse 2, is a telephonic environment, assesses and evaluates OB members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Reports to the Regional CM Manager. The Women's Health Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental, mental health/substance abuse and psycho-social health issues.
Requirements
- Registered Nurse License in the State of Florida with no disciplinary action
- 3+ years of Women's Health, Obstetric or Labor & Delivery experience
- Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
- Tuberculosis (TB) Screening This role is considered patient facing and is a part of Humana's AHCA II Level Background Clearance
- Associates working in the State of Florida will need AHCA Level II Background clearance
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Nice To Haves
- BSN
- 1+ year Substance Use/Addiction/Behavioral/Mental Health experience
- Experience with case management, discharge planning and patient education
- Bilingual English/Spanish or English/Creole
- Managed care experience
- Certified Case Manager (CCM)
Responsibilities
- 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.
- May create member care plans.
- Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
- Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
- Follows established guidelines/procedures.
- Reside in Florida and occasionally attend meetings in the market office.
Benefits
- medical
- dental
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
