Care Manager, Telephonic Compact Registered Nurse

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.

The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by providing care coordination to members/families 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. Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. 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 patients are 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.

The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. This is a fast-paced environment and requires the ability to engage quickly with members while concurrently navigating multiple computer applications. To ensure compliance and support the auto dialer process essential to our business, the daily schedules of care managers must remain structured. As a result, day-to-day flexibility is limited. 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 work with Medicare members with transitional needs and complex chronic conditions. Assess member’s physical, environmental, and psycho-social health issues, and work in collaboration with a multi-disciplinary team, employing a variety of strategies/techniques to manage appropriately and provide timely clinical intervention. Evaluate members’ risks, coordinate care, and provide clinical interventions to prevent avoidable hospitalizations. Collaborate with members who face multiple chronic conditions, along with financial and functional challenges, to support them in achieving and sustaining optimal health.