[Remote] NICU Care Manager, Telephonic Nurse at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Licensed Registered Nurse (RN) in the appropriate state with no disciplinary action
Active Compact RN license with the ability to apply for additional licensure without restrictions if needed
2 years or more of case management experience
Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
Ability to work independently under general instructions and with a team
Team player
Strong organizational skills and experience multi-tasking

Responsibilities

Assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitating interaction with appropriate resources
Employ a variety of strategies, approaches, and techniques to manage a member’s physical, environmental, and psycho-social health issues
Follow members from the beginning of their NICU stays until 30 days post-discharge
Identify and utilize appropriate healthcare resources most consistent with the member’s needs and provide guidance along the healthcare continuum
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
May create member care plans
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

Skills

Key technologies and capabilities for this role

Registered Nurse (RN)Case ManagementNICUTelephonic CareMicrosoft WordMicrosoft ExcelMicrosoft OutlookCare PlanningPatient Assessment

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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