RN Care Manager

Kentucky, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must reside in Kentucky or a bordering county on the Kentucky border, hold an unrestricted Registered Nurse license in Kentucky, and possess at least 2 years of case/care management experience. Required skills include knowledge of community health and social service agencies, exceptional communication and interpersonal abilities for building rapport, and intermediate to advanced computer skills with proficiency in Microsoft Word, Outlook, and Excel. The role also requires the ability to use various electronic information applications and software programs, including electronic medical records.

Responsibilities

The Field Care Manager Nurse assesses and evaluates member needs to optimize their wellness state, guiding them toward appropriate resources. This involves employing diverse strategies to manage members' physical, environmental, and psychosocial health, identifying and resolving care barriers, and monitoring patient progress towards desired outcomes through continuous assessment. The role may involve creating member care plans and requires independent decision-making regarding work methods with minimal direction, following established guidelines. The position is primarily telephonic, with approximately 10% of work involving field visits within a 30-40 mile radius. Additionally, the role requires maintaining a valid state driver's license, personal vehicle liability insurance, and a dedicated, interruption-free workspace. TB screening is also a requirement.

Skills

Case Management

Care Management

Community Health

Social Service Agencies

Microsoft Word

Microsoft Outlook

Microsoft Excel

Electronic Medical Records

Motivational Interviewing

Bilingual (English/Spanish)

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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