Telephonic Nurse 2 (Care Manager) Bilingual English/Spanish

Kentucky, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must possess a Bachelor of Science in Nursing (BSN) and 3-5 years of clinical acute care experience. A valid Registered Nurse (RN) license with no disciplinary action is required, along with residency in OH, KY, IN, FL, AZ, or TX. Proficiency in Microsoft Office applications (Word, Excel, Outlook) and managed care experience are necessary. Bilingual English/Spanish skills are also required. Preferred qualifications include experience with care management, patient education for adult acute care, and auto dialer experience.

Responsibilities

The Telephonic Nurse 2 (Care Manager) will assess and evaluate the health conditions of members, particularly those with complex and rare diseases, focusing on medication therapy. Responsibilities include developing and implementing comprehensive care plans, monitoring patient progress through telephonic assessments, and providing medication education using advanced telecommunication systems. The role involves performing inbound and outbound tasks within a set schedule, including occasional late nights and holiday rotations, with potential for overtime.

Skills

Registered Nurse

BSN

Patient Management

Medication Therapy

Care Planning

Telephonic Assessment

Communication Skills

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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