Rn Care Manager - Remote, Nationwide

The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. 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.

Responsibilities

The first 4 weeks of training will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training. Following training, the start time is 10:00AM EST.

Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We contact members with multiple chronic conditions as well as financial and functional barriers in order to assist them in achieving and maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence, while using a multidisciplinary team.

This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care Managers are work at home associates, working from a dedicated home office space. Work at home care managers are responsible for meeting quality and productivity measures daily and maintaining working home internet at all time with demonstrated advanced communication and interpersonal skills.

This is a very compliance driven and highly visible program at Humana. The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. Environment is fast paced and requires ability to engage quickly with member while concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility in care manager’s schedule.

Duties:

• Use nursing judgment to assess and coordinate care for acute situations (APS, EMS)
• Assess member’s physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention
• Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
• Telephonically assess Medicare, Medicaid, and/or and Group Account members and create actionable and measurable care plans to help guide and track the members' progress toward goals
• Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc.

Click here to learn about a "Day in the Life" of our remote RN Care Managers.

Day In The Life RN SNP Care Manager - YouTube

Required Qualifications

• Intermediate to advanced computer skills as evidenced by ability to navigate multiple systems, utilizing dual computer monitors.
• Must possess advanced telephonic and virtual communication skills.
• Effective communication and interpersonal skills.
• The National Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one license and the ability to practice in all the states that participate in the program. License must be current with no disciplinary action.
• Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues.
• Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.
• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
• Experience with Microsoft and Excel
• Hold an active Compact nursing license and reside in the state that holds your compact license.
  • The National Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one license and the ability to practice in all the states that participate in the program. License must be current with no disciplinary action.
• Demonstrated clinical knowledge and expertise as evidenced by providing intervention to manage variety chronic conditions, including development and implementation of individualized care planning.
• Effective problem solving and appropriate application of clinical knowledge
• Seasoned RN with a minimum of 3 years of clinical nursing experience.
• Ability to quickly learn and navigate software programs and applications.
• Minimum education of an Associates degree in Nursing.
• Active Registered Nurse (R.N.) license with no disciplinary action.

Preferred Qualifications

• Experience with MCG or CMS guidelines, assessment and documentation practice
• Previous experience in care management including knowledge of complex care management and care management principles
• BSN or MSN degree in nursing or equivalent
• Previous adult chronic conditions care management
• Individual licenses in non-compact states
• Experience with motivational interviewing
• CCM
• Bi-lingual in Spanish and English

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• Associates 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.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
• 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
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Satellite, cellular and microwave connection can be used only if approved by leadership

Scheduled Weekly Hours

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