Telephonic Care Manager RN - Women's Health

The Women's Health Care Manager, Telephonic Nurse 2 , is a telephonic environment, assesses and evaluates OB members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Reports to the Regional CM Manager.

The Women's Health Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental, mental health/substance abuse and psycho-social health issues.

Shift Schedule: Monday through Friday 10:30 -7:00 PM Eastern

Role Overview

• Identifies and resolves barriers that hinder effective care.
• Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.
• May create member care plans.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Follows established guidelines/procedures.
• Reside in Florida and occasionally attend meetings in the market office (See additional information)

Required Qualifications

• Registered Nurse License in the State of Florida with no disciplinary action
• 3+ years of Women's Health, Obstetric or Labor & Delivery experience
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
• Tuberculosis (TB) Screening​ This role is considered patient facing and is a part of Humana's
• AHCA II Level Background Clearance Associates working in the State of Florida will need AHCA Level II Background clearance
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

• BSN
• 1+ year Substance Use/Addiction/Behavioral/Mental Health experience
• Experience with case management, discharge planning and patient education
• Bilingual English/Spanish or English/Creole
• Managed care experience
• Certified Case Manager (CCM)

Additional Information

Workstyle: Remote work at home Location: Florida Shift Schedule: Monday through Friday 10:30 -7:00 PM Eastern Travel: occasion travel to market office for meetings

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

$71,100 - $97,800 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.