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Humana

Care Manager, Telephonic Nurse

Case ManagementRNNot SpecifiedFull-timeDay (8:00 a.m. – 6 p.m. EST (Eastern Standard Time)), Standard (Mon-Fri)Remote, Nationwide$71,100 to $97,800 per year

Job description

We appreciate that you are interested in pursuing your next career opportunity. As you complete the application below, here are a few tips you should consider: • Visit Go/Develop for information on professional development, resume guidance, and interview best practices.​ • Watch a quick video to discover how Humana’s Career Framework can help you identify meaningful growth opportunities. • Visit Go/AskARecruiter for expert advice on your job search from our Talent Acquisition Team. • Tailor your resume to highlight achievements and skills that align with the role you're applying for. • Update your Workday profile to reflect your key accomplishments and experiences. • Please read the job description carefully and ensure you meet all required qualifications. • Consider having a conversation with your current leader about your career goals and interest in this opportunity. Their support can be valuable as you explore your next step. Job Profile Care Manager, Telephonic Nurse 2 Job Level Professional 2 Become a part of our caring community As a remote Telephonic Care Manager you will report to a Manager of Care Management. You will be providing a comprehensive, holistic approach for Case Management (CM) Special Populations program throughout the continuum of care. You will provide case management specialized interventions by leveraging the most appropriate care sites and levels of care to prevent or decrease hospital readmissions, promoting appropriate utilization of alternative sources of available funding, enhancing coordination of care, and reducing fragmentation of clinical services. You will serve as the point of contact in the Special Populations Program for the beneficiary for all activities within the clinical spectrum. You will coordinate and collaborate within the Care Management programs, Military Treatment Facility (MTF) Utilization Management/Case Management/CM staff, physicians or providers to ensure there is a fully integrated care plan addressing all beneficiary needs and conditions. Use your skills to make an impact ​

Responsibilities

Requirements

  • • Our Department of Defense Contract requires U.S. citizenship for this position. • Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services) • HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico. • Active RN license in state of employment • Ability to obtain CCM certification within 1 year of hire • 2 years case management experience • 3 years clinical RN or managed care RN experience • Bachelor's degree in nursing • TRICARE experience • Experience with MCG • Current CCM Additional Information Work Style: Remote Work Schedule: Monday – Friday; must be able to work an 8-hour shift between the hours of 8:00 a.m. – 6 p.m. EST (Eastern Standard Time) Training/Training Hours: Mandatory for the first 4 weeks between the hours 8:00 a.m. – 5:00 p.m. EST (Eastern Standard Time) Work at Home Requirements To ensure Hybrid Office/Home associates' ability to work effectively, the self-provided internet service of Hybrid Office/Home associates 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 connection can be used only if approved by leadership • 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. • Humana will provide Home or Hybrid Home/Office associates 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 Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, 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. This incentive opportunity is based upon company and/or individual performance. Referral Bonus Information This requisition is not eligible for a referral bonus. Application Deadline: 09-03-2026

About Humana

Humana's Primary Care Organization operates 340+ senior-focused primary care centers across 15 states under the CenterWell and Conviva brands, providing value-based care to adult and geriatric patients. They hire Nurse Practitioners for part-time roles in collaborative, team-based primary care settings with lower patient volumes, and they hire bilingual Registered Nurses for remote telephonic care management positions supporting members with chronic and complex health conditions, requiring assessment, care planning, and coordination with interdisciplinary teams.

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