[Remote] Care Manager, Telephonic Nurse 2 at Humana

Arizona, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Bachelor of Science in Nursing (BSN) (REQUIRED)
3 - 5 years of clinical acute care experience
Licensed Registered Nurse (RN) in the appropriate state with no disciplinary action
Must live in OH, KY, FL, AZ, TX
Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
Managed care experience
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Schedule adherence (10am-6:30pm EST three days a week M-F, 11:30am-8pm EST two days a week, Friday late night rotation 11:30am-8pm, Saturday rotation 8:30am-12:30pm, overtime as needed, holiday rotation including MLK Day, Memorial Day, Juneteenth, 4th of July, Labor Day, day after Thanksgiving, New Years Day)

Responsibilities

Assess and evaluate members' conditions, with 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
Perform inbound and outbound tasks in a call center-based environment
Adhere to established protocols and guidelines while working independently
Focus on patients with specialized and complex health conditions (autoimmune disorders, pulmonary diseases, neuromuscular disorders, infectious diseases, cancer(s), and other rare ailments)

Skills

Key technologies and capabilities for this role

BSNRegistered NurseTelephonic Care ManagementPatient AssessmentCare PlanningMedication TherapyClinical ExpertiseCommunication Skills

Questions & Answers

Common questions about this position

What are the required qualifications for this Care Manager role?

Candidates must have a Bachelor of Science in Nursing (BSN), 3-5 years of clinical acute care experience, be a licensed Registered Nurse in the appropriate state with no disciplinary action, live in OH, KY, FL, AZ, or TX, and possess comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook.

What is the work schedule and location policy for this position?

This is a call center based environment with a set schedule: 10am-6:30pm EST three days a week M-F, two days a week 11:30am-8pm EST, rotating Friday late nights, rotating Saturday 8:30am-12:30pm, required overtime as needed, and holiday rotations. Candidates must live in OH, KY, FL, AZ, or TX.

What salary or compensation is offered for this role?

This information is not specified in the job description.

What does the work environment look like for this position?

This is a call center based environment focused on telephonic interactions in a supportive and professional setting, with a set daily schedule including inbound and outbound tasks, schedule adherence preferred, and rotations for weekends and holidays.

What makes a strong candidate for this Care Manager position?

Ideal candidates demonstrate strong clinical expertise, exceptional communication skills, the ability to work independently while adhering to protocols, managed care experience, and passion for improving consumer experiences, along with strict schedule adherence.

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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