[Remote] Field Care Manager - RN at Humana

Illinois, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, MedicaidIndustries

Requirements

Must reside in the state of Illinois, preferably in Central Illinois
Registered Nurse (RN) license in the state of Illinois without disciplinary action
Clinical nursing experience required (hospital, acute care, or home health)
Ability to travel 75-90% within the state of Illinois
Knowledge of community health and social service agencies and additional community resources
Exceptional communication and interpersonal skills with the ability to quickly build rapport
Ability to work with minimal supervision within the role and scope
Ability to use a variety of electronic information applications/software programs including electronic medical records
Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel
Participation in Humana's Tuberculosis (TB) screening program (patient-facing role)
Valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits (Humana's Driver Safety Program)
Minimum internet speed of 25 Mbps download and 10 Mbps upload for work-from-home setup

Responsibilities

Assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members and families toward appropriate resources
Employ a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues
Identify and resolve barriers that hinder effective care
Ensure patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations
Create plans of care
Communicate with internal and external stakeholders
Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas
Make decisions regarding own work methods, occasionally in ambiguous situations, with minimal direction and guidance where needed
Follow established guidelines/procedures
Visit Medicaid members in their homes, Supportive Living Facilities, Long-Term Care Facilities, and other care settings (75-90% local travel)

Skills

Registered Nurse

Clinical Nursing

Home Health

Care Planning

Patient Assessment

Care Coordination

Community Health Resources

Interpersonal Communication

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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