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Care Manager, Telephonic Nurse
hace 2 semanas
Join to apply for the Care Manager, Telephonic Nurse role at Humana. This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $71,100.00/yr - $97,800.00/yr Become a part of our caring community and help us put health first. The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Associates will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. The nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. 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. Employs a variety of strategies, approaches and techniques to assess, intervene, and resolve Access to Care (ATC) barriers related to immediate medical services. Facilitates verified eligible Humana benefits to a provider and/or member while effectively documenting through assessments and/or evaluations while maintaining compliance with CMS regulations. Assesses for member physical, environmental, and psycho-social health issues and intervenes appropriately. Required Qualifications Minimum of an Associate’s degree in Nursing Licensed Registered Nurse (RN) with no disciplinary action Must have a valid Compact RN license in the state where they reside. Candidates must reside in a Compact state (excluding CA, IL, MI, NY, OR, AK, DC, HI, NV, MA, MN, and PR). 3 years or more of clinical acute care experience Comprehensive knowledge of all Microsoft programs including but not limited to Word, Outlook, PowerPoint, SharePoint, OneNote and Excel Preferred Qualifications Bachelor's degree – BSN Experience with case management, discharge planning, and patient education for adult acute care Managed care experience Previous Medicare/Medicaid experience Bilingual English/Spanish Additional Information Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. Work At Home / Internet Statement To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria. At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi‑weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Alert Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana’s secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours: 40 Benefits: Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well‑being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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. Application Deadline: About Us: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Seniority level Mid‑Senior level Employment type Full‑time Job function Health Care Provider Industries Insurance #J-18808-Ljbffr
