RN, Care Manager, Telephonic Nurse - Remote Eligible

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Humana Gold Plus Integrated is seeking a RN, Care Manager, Telephonic Nurse 2 who will assess and evaluate member's needs with emphasis on discharge planning on preventing rehospitalization, monitoring, and managing chronic conditions effectively, in a telephonic environment. This position supports members in addressing their health care needs by helping them access appropriate services, skills, and support needed to achieve optimal health and life functioning independence in the community.

The RN, Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities include:

• Strengthens care management activities and supports improving members well-being, reducing unnecessary healthcare costs and enhancing healthcare delivery.
• Assesses, monitors, and evaluates members' chronic condition as well as provide and document meaningful interventions and outcomes.
• Provides episodic care coordination focusing on education and support to enhance lifestyle modifications and self-management techniques.
• Collaborate with Care Coordinators and other identified care team members as needed along with utilization management (UM) staff, physicians and providers as necessary and arrange services necessary to address the member's condition and current needs.
• May contribute to interdisciplinary care planning and meetings.
• Meet requirements for contractual and regulatory compliance.
• Makes decisions regarding your own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Follows established guidelines/procedures.
• Other duties as required.

Use your skills to make an impact.

Required qualifications:

• Applicants are required to live in the state of Illinois.
• An active, unrestricted Registered Nurse (RN) license in the state of Illinois.
• Three (3) or more years of clinical experience as a RN with demonstrated expertise in educating patients/members on the management of chronic health conditions.
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook.
• Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
• Knowledge of community health and social service agencies and additional community resources.
• Exceptional oral and written communication.

Preferred qualifications:

• Bachelor's degree in nursing (BSN).
• Case Management Certification (CCM).
• Managed Care experience.
• Certified Diabetes Educator.
• Certified Asthma Educator.

This is a remote position with occasional travel to onsite team engagement meetings in Humana's Schaumburg, IL office. Work schedule is Monday - Friday; 8:00 AM - 5:00 PM Central Standard Time (CST).

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.