Care Manager, Telephonic Nurse 2

Overview Become a part of our caring community. The individual in this role will work as an Oklahoma-based, primarily telephonic care manager. This care manager will assess and evaluate enrollees\' needs and requirements to achieve or maintain optimal wellness. The care manager will guide enrollees/families toward and facilitate interaction with appropriate resources for their care and wellbeing. The Care Manager, Telephonic Nurse 2 work assignments are varied but will focus on those enrollees with a primary physical health diagnosis. This role requires interpretation and independent determination of appropriate actions and may require home or facility-based visits to enhance enrollee engagement and services. You will work in collaboration with the interdisciplinary care management team, which includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. This team-based approach ensures enrollees receive holistic person-centered care management. The Care Manager, Telephonic Nurse 2 will utilize clinical expertise to determine when face-to-face enrollee support is required and will engage the appropriate members of the care management team and/or coordinate in-person meetings between the care manager and the enrollee. Responsibilities Include Employs a variety of strategies, approaches, and techniques to manage an enrollee’s behavioral, physical, environmental, and psycho-social health needs. Ensures enrollees are progressing toward desired outcomes by continuously monitoring assessments and evaluations. Identifies and resolves barriers that hinder effective care and ensures progress toward desired outcomes through continuous monitoring. Creates enrollee care plans and understands department, segment, and organizational strategy and operating objectives, including linkages to related areas. Makes decisions about work methods, occasionally in ambiguous situations, and requires minimal direction with guidance where needed. Performs telephonic and face-to-face assessments and evaluations of the member\'s needs and requirements to achieve and/or maintain an optimal wellness state and guide members/families toward appropriate resources. Ensures member progress toward desired outcomes by monitoring care through assessments and/or evaluations. Collaborates with providers and community services to promote quality and cost-effective outcomes. Follows established guidelines/procedures. Possible travel to Humana Oklahoma office for meetings and training. Required Qualifications Must reside in Oklahoma. Active Registered Nurse (RN) license, Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW). Minimum 1-year clinical experience. 2 or more 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 additional community resources. Exceptional communication and interpersonal skills with the ability to quickly build rapport. Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint. Preferred Qualifications Case Management Certification (CMC). Bilingual Spanish Speaking. Additional Information WAH 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 recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connections 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 business requirements. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Benefits Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Other Information HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. SSN Alert Humana values personal identity protection. Applicants may be asked to provide their Social Security Number if it is not already on file. When required, an email will be sent with instructions to add the information into your official Humana application. Travel: This is a remote position, but occasional travel to Humana\'s offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good-faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan based upon company and/or individual performance. Description Of Benefits Humana offers competitive benefits that support whole-person well-being, including medical, dental and vision benefits, 401(k) retirement savings plan, time off, disability, life insurance, and other opportunities. About Us Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through Humana insurance services and CenterWell healthcare services, we make it easier for millions of people we serve to achieve their best health. Learn more at Humana.com and CenterWell.com. Equal Opportunity Employer Humana is an equal opportunity employer. It is the policy of Humana not to discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to comply with all applicable laws and regulations in employment decisions. #J-18808-Ljbffr Humana