Care Manager, Registered Nurse, RN

About the role

The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness. This role guides members and families toward and facilitates interaction with resources appropriate for their care and well-being. Work assignments are varied and frequently require interpretation and independent determination of appropriate courses of action.

You will report to the Associate Director, Health Services Nursing. The role employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. Responsibilities include identifying and resolving barriers that hinder care, ensuring patient progress toward desired outcomes through assessments and evaluations, and potentially creating member care plans. The role requires understanding department, segment, and organizational strategy and operating goals, including their linkages to related areas, while following established guidelines and procedures.

Responsibilities

• Assess and evaluate members' needs to achieve and/or maintain optimal wellness.
• Guide members and families toward appropriate resources for care and well-being.
• Identify and resolve barriers that hinder care.
• Monitor patient care through assessments and evaluations to ensure progress toward desired outcomes.
• Create member care plans as needed.
• Understand and align with department, segment, and organizational strategy and operating goals.

Requirements

• 3 or more years of clinical acute care experience.
• Licensed Registered Nurse (RN) in the state of South Carolina with no disciplinary action.
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook.

Preferred Qualifications

• South Carolina Resident.
• Bachelor's degree.
• Experience with case management, discharge planning, and patient education for adult acute care.
• Managed care experience.
• Certified Case Manager (CCM).

Work at Home Requirements

To ensure effective remote work, the following criteria must be met:

• Self-provided internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable, or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information.
• Occasional travel to Humana's offices for training or meetings may be required.

Pay

The pay range for this full-time (40 hours per week) position is $71,100 - $97,800 per year. The range may vary based on geographic location, and individual pay will depend on demonstrated job-related skills, knowledge, experience, education, and certifications. This role is eligible for a bonus incentive plan based on company and/or individual performance.

Benefits

Humana offers competitive benefits designed to support whole-person well-being, including:

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off, including paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short-term and long-term disability.
• Life insurance.

About Us

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through Humana insurance services and CenterWell healthcare services, we make it easier for millions of people to achieve their best health by delivering care and services when needed. Learn more at Humana.com and CenterWell.com.