Role: Disease Management Nurse Assignment: Humana Government Business Location: WAH - location can vary
The Disease Management Nurse will be a member of the HGB Integrated Care Team (ICT) encompassing Disease Management, Case Management, and the Personal Nurse program; providing a comprehensive, holistic approach for care management throughout the continuum of care. The Disease Management nurse will offer guidance and support of the beneficiary’s care as directed by the patient’s provider(s) and within the scope of the clinician’s licensure. The Disease Management Nurse will assess and engage beneficiaries for enrollment in Humana Government Business disease management program(s). Plan, coordinate, implement, monitor, and evaluate the medical services required to meet the complex health needs of TRICARE beneficiaries enrolled in a Humana Government Business ICT Programs, to maximize each beneficiary’s capacity for self-care, to cost-effectively achieve desired clinical outcomes, and to enhance quality of medical care. Coordinate care with other ICT members as needed along with MTF UM staff, physicians and providers as necessary and arrange services necessary to address the beneficiary’s condition and current needs. Coordinate and collaborate services with other care management programs, to include, but not limited to, Humana at Home, New Beginnings, and End of Life services until the beneficiary’s needs are met and case closure or graduation is achieved. Performs all duties within the scope of her/his licensure.
Role Essentials * Our Department of Defense Contract requires U.S. citizenship for this position.
Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)
Active licensed RN in state of employment
Case Management Certification (CCM)
Three years clinical experience in a hospital/outpatient clinic. Must have three years psychiatric experience if position is for depression/anxiety disorder DM program.
Computer skills Role Desirables
Bachelors degree in nursing (BSN)
Two years disease management experience
Managed Care Experience
Certified Diabetes Educator
Certified Asthma Educator
Title: Disease Management Nurse
Requisition ID: 176936