The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward 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.
The Disease Management Nurse 2 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 2 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 2 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.
•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 RN experience• Computer skills
•Bachelors degree in nursing (BSN)•Two years disease management experience•Managed Care Experience•Bilingual•Certified Diabetes Educator•Certified Asthma Educator
Scheduled Weekly Hours
Equal Opportunity Employer
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