Humana Health Planning & Support Telephonic RN - Work at Home in Fargo, North Dakota

Role: Clinical Advisor, RN

Assignment: Health Planning and Support

Location: Work at home , 9:30 - 6:00 Eastern or 11:30 - 8:00 pm Eastern

Humana’s dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor. Humana’s Perfect Service® means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members. We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares.

** Role Description

Be a part of the clinical world – Engage Humana members with health and well-being advice.

Humana is seeking a Health Planning and Support (HPS) nurse to provide Humana members with general nurse advice; accepting inbound phone calls from members seeking assistance with medical questions. Nurses are trained to act as a clinical concierge, guiding members to resources, programs and/or healthcare providers for assistance with managing chronic conditions or medical advice. The HPS nurse assesses and identifies specialty program eligibility for members with increasing need for personal health guidance. HPS Nurses will also place outbound calls to members for education and counseling on the importance of preventive screenings and treatment or medication adherence.

Role Essentials

  • Active, unrestricted RN license in a Nurse Licensure Compact (NLC) state: Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin.

  • Ability to be licensed in multiple states without restrictions

  • Three or more years of clinical experience; preferably in an acute care, skilled or rehabilitation clinical setting
  • Previous insurance experience or workers comp experience

  • Ability to work independently under general instructions and with a team

  • Ability to travel up to 10% annually

Role Desirables

  • BSN or Bachelor’s degree in a related field

  • Health Plan experience

  • Call center or triage experience

  • Previous case management or utilization review

  • Bilingual - fluent in both English and Spanish

Additional Information

Humana is an organization with careers that change lives—including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Title: Health Planning & Support Telephonic RN - Work at Home

Location: Texas-San Antonio

Other Locations: US-AZ-Phoenix, US-KY-Louisville, US-Idaho-Meridian, US-Iowa-Davenport, US-TN-Brentwood, US-Colorado-Colorado Springs, US-New Mexico-Albuquerque, US-Nebraska-Omaha, US-Delaware-Dover, US-WI-Green Bay, US-Mississippi-Ridgeland, US-North Carolina-Charlotte, US-Maine-Portland, US-North Dakota-Fargo

Requisition ID: 178361