Role:Frontline Leader (Social Worker/RN/LPN)
Assignment:Humana Long -Term Care
Location:Work At Home – Miami Dade County, FL
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.
Be part of a clinical leadership team, where we provide innovative health solutions to members and providers.
Humana Long -Term Care is seeking a work-at-home Frontline Leader who will hire, lead, and develop clinical and non- clinical professional associates. You will oversee the daily, onsite, and medical management activities of a team of Care Coaches. You will collaborate with health care givers in reviewing actual and proposed medical care and services against established Guidelines.
As a Frontline Leader you will:
Develop system-view recommendations
Implement appropriate actions to control trend
Create and conducts provider outreach initiatives
Ensure compliance with regulatory requirements
Recommend services for Humana Plan members utilizing care alternatives available within the community and nationally
Recommend alternatives if appropriate using your knowledge of clinical protocols
Identify members for specific case management and / or disease management activities
Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions
Requires 25% travel, the rest will be work from home.
The Frontline Leader shall meetoneof the following qualifications:
Master's Degree in human services, social sciences, or health related field with at least 2 years of case management experience with at least 1 year focused on elderly or disabled population.
Bachelor's Degree in a health related field with at least 5 years of case management experience with at least 1 year focused on the elderly or disabled population.
9 years of professional human service experience with a minimum of 5 years of case management experience with at least 1 year focused on the elderly or disabled population.
The Frontline Leader shall meetallof the following qualifications:
Bilingual English/Spanish - able to speak, read and write in both languages without limitations or assistance.
All Registered Nurses (RN) or Licensed Practical Nurses(LPN) must be licensed in the state of Florida without restrictions.
This role is part of Humana’s Driver safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.
Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work.
Must have accessibility to high speed DSL or Cable modem for a home office (No Satellite).
Intermediate to advanced computer skills and experience with Microsoft Word, Excel and Outlook
This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
AHCA Fingerprint Required.
Previous leadership experience.
BSN or Bachelor’s degree in a related field.
Health Plan experience.
Previous Medicare/Medicaid Experience a plus.
Call center or triage experience.
Previous experience in utilization management, discharge planning and/or home health or rehab.
Prior nursing home diversion or long term care case management experience.
Experience with health promotion, coaching and wellness
Experience working with the geriatric population.
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.
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence(please be sure to check your spam or junk folders often to ensure communication is not missed)inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Title: Frontline Leader (Bilingual - Spanish/English) - Miami Dade County, FL
Requisition ID: 178696