Care Manager, RN - Medicaid

Humana

1d • Remote

About The Position

Become a part of our caring community and help us put health first The Care Manager Nurse 2 works primarily in a telephonic environment. The nurse assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state. The nurse 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. Additionally, you will be in a field role and will require up to 25% travel visiting members or facilities within the state of South Carolina. The Care Manager Nurse 2 employs a variety of strategies and techniques to manage a member's physical, environmental and psycho-social health issues. Medicaid population experience preferred. Identify and resolve barriers that hinder care. Ensure patient is progressing towards desired outcomes by monitoring patient care through assessments and evaluations. Create member care plans. Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Use your skills to make an impact

Requirements

• Unrestricted Current Licensed Registered Nurse (RN) in the state of South Carolina or a compact license with no active disciplinary action
• Must live in the state of South Carolina
• 3 or more years of clinical acute care experience
• 1 or more years case management, care coach, or care coordination
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
• Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Nice To Haves

• Bachelor's degree
• Medicaid or Managed care experience
• Experience with case management, discharge planning and patient education for adult acute care
• Certified Case Manager (CCM)

Responsibilities

• Assess and evaluate members' needs and requirements to achieve and/or maintain optimal wellness state.
• Guide members/families toward and facilitates interaction with resources appropriate for the care and wellbeing of members.
• Employ a variety of strategies and techniques to manage a member's physical, environmental and psycho-social health issues.
• Identify and resolve barriers that hinder care.
• Ensure patient is progressing towards desired outcomes by monitoring patient care through assessments and evaluations.
• Create member care plans.
• Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees