Care Manager, Telephonic Nurse

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About the role

Become a part of our caring community   The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements. This is done to achieve and/or maintain optimal wellness state. The Care Manager guides members/families toward and facilitates 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. You will report to the Manager, Care Management Responsibilities:   • Conducts telephonic assessments to identify members’ clinical, behavioral, social, and environmental needs. • Identifies and resolves barriers that hinder effective care or treatment adherence. • Develops, implements, and updates individualized care plans, as appropriate. • Monitors member progress toward desired outcomes through ongoing assessment and evaluation. • Provides education and support for chronic conditions management and self-care. • Coordinates care and facilitates access to appropriate providers, services, and community resources. • Collaborates with members, families, providers, and interdisciplinary teams to support care goals. • Maintains timely and accurate documentation in accordance with established guidelines and quality and compliance requirements. • Applies department, segment, and organizational policies, procedures and operational objectives in day to day work to support established strategy and operating objectives. • Exercises independent judgment and utilizes available resources in managing assigned caseloads, occasionally in ambiguous situations, with minimal direction and guidance. • Up to 20% travel may be required due to business needs, including member outreach and meetings. In this role, you will have the opportunity to make a meaningful impact by supporting members through care coordination, education, and resource connection that improves health outcomes and quality of life.   This position primarily works standard business hours; however, schedule flexibility may be required based on business needs. Use your skills to make an impact   Required Qualifications • Active, unrestricted Registered Nurse (RN) license in the state of South Carolina with multistate compact privileges and no disciplinary action • Must reside in the state of South Carolina • 3+ years of recent acute care clinical nursing experience • Experience providing education and support for chronic condition management • Experience with community resource coordination • Proficiency with Microsoft Office applications, including Word, Excel, and Outlook • Strong documentation, multitasking, and computer navigation with basic troubleshooting skills Preferred Qualifications • Bachelor of Science in Nursing (BSN) • Experience in telephonic case management, care management, discharge planning, transitions of care and patient education in an adult acute care setting • Managed care experience • Medicare & Medicaid population experience • Behavioral health management awareness • Telephonic nursing experience • Certified Case Manager (CCM) 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 dedica

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