[Remote] Bilingual Telephonic RN 2, Care Manager at Humana

Florida, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor of Science in Nursing (BSN)
3 - 5 years of clinical acute care experience
Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action
Bilingual English/Spanish
Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
Managed care experience
Must live in OH, KY, FL, AZ, TX
Passionate about contributing to an organization focused on continuously improving consumer experiences

Responsibilities

Assess and evaluate the conditions of members, with a particular emphasis on medication therapy, through telephonic interactions
Develop and implement comprehensive care plans
Monitor patient progress through regular assessments
Utilize advanced telecommunication systems to provide medication education
Adhere to established protocols and guidelines
Perform inbound and outbound tasks as per a set daily schedule
Work late nights and weekends as required, including scheduled late nights and Friday night late night rotation
Work on a holiday rotation
Work overtime as needed

Skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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