Humana RN Telephonic Case Manager - GA & SC in Work at Home, South Carolina

Description

The Case Manager, 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.

Responsibilities

The hours of this role are Mon-Fri, 8am-5pm, est.

The Telephonic Case Manager employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

  • 3-5 years of clinical acute care experience

  • Experience with case management, discharge planning and patient education for adult acute care

  • Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action

  • Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook

Preferred Qualifications

  • Knowledge of Milliman or Interqual

  • Managed care experience

  • Certified Case Manager (CCM)

Additional Information

Scheduled Weekly Hours

40

About Us

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.