Care Manager, Telephonic Nurse

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Provide comprehensive, holistic case management for complex medical cases throughout the continuum of care • Deliver specialized interventions using appropriate care sites and levels of care • Prevent or decrease hospital readmissions • Promote appropriate utilization of alternative funding sources • Enhance coordination of care and reduce fragmentation of clinical services • Serve as the beneficiary's point of contact for activities across the clinical spectrum • Coordinate with Care Management programs, Military Treatment Facility utilization management and case management staff, and providers • Ensure fully integrated care plans address all beneficiary needs and conditions • Report to a Manager of Care Management

🎯 Requirements

• U.S. citizenship required for the Department of Defense contract • Successfully receive interim approval for government security clearance (NBIS) • Cannot currently live in Puerto Rico • Active RN license in state of employment • Ability to obtain CCM certification within 1 year of hire • 2 years of case management experience • 3 years of clinical RN or managed care RN experience • Must work Monday–Friday, either 8 a.m.–5 p.m. ET or 9 a.m.–6 p.m. ET • Bachelor's degree in nursing preferred • TRICARE experience preferred • Experience with MCG preferred • Current CCM preferred • Home internet with at least 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions to protect PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Dedicated home workspace and internet requirements for remote work • Occasional travel to Humana offices for training or meetings