RN Care Manager - Remote, nationwide

San Antonio, Texas, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must possess an active Registered Nurse (R.N.) license with no disciplinary action, and hold an active Compact nursing license residing in the state that holds the compact license. A minimum of an Associate's degree in Nursing and at least 3 years of clinical nursing experience are required, demonstrating clinical knowledge and expertise in managing chronic conditions and care planning. Intermediate to advanced computer skills are necessary for navigating multiple systems.

Responsibilities

The RN Care Manager will telephonically assess members, create actionable care plans, and monitor progress towards goals. Responsibilities include assessing and coordinating care for acute situations, discussing transitions of care for safe discharge, and guiding members toward appropriate resources. The role involves assessing members' physical, environmental, and psycho-social health issues, collaborating with a multidisciplinary team, and managing chronic conditions through various strategies and timely interventions.

Skills

Telephonic Outreach

Chronic Condition Management

Health Education

Resource Identification

Barrier Removal

Multidisciplinary Team Collaboration

Special Needs Program (SNP)

Advanced Communication Skills

Interpersonal Skills

Compliance

Computer Application Navigation

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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