Job Description
Become a part of our caring community As a Telephonic Nurse Care Manager with Humana Gold Plus-Integrated in Illinois, you will play a pivotal role in truly transforming the lives of our members. By providing personalized assessments, ongoing care planning, and expert guidance over the phone, you will help members overcome barriers to care, manage chronic conditions, and connect with vital resources-empowering them to achieve and maintain their best possible health. Your clinical expertise and compassionate support will have a lasting impact, helping individuals and families navigate complex health challenges and improving their overall well-being. Join our team to make a difference, one member at a time.
- Works with an assigned member population in Illinois over the phone performing health assessments, care planning, and education on chronic conditions and any gaps in their health care plans.
- Employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.
- Identifies and resolves barriers that hinder effective care.
- Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning.
- Navigates multiple systems and uses critical thinking skills.
Use your skills to make an impact Required Qualifications - Bachelor's degree in nursing (BSN) or health related field.
- Licensed Registered Nurse (RN) in the state of Illinois with no disciplinary action or ability to obtain IL RN licensure.
- Minimum of 3 years of clinical acute care experience as a licensed RN.
- Experience with health promotion, coaching and wellness.
Preferred Qualifications - Bilingual in English/Spanish, English/Polish, or English/Creole.
- Experience with case management, discharge planning and patient education for adult acute care.
- Managed care experience.
- Certified Case Manager (CCM).
- Prior experience with Medicare & Medicaid recipients.
- Knowledge of community health and social service agencies and additional community resources.
Additional Information - Workstyle: Remote, work from home.
- Typical work days/hours: Monday - Friday, 8:00am - 5:00pm CST, occasional flexibility in scheduling may be required to accommodate member needs.
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 The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$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.
Description of Benefits 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. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Job Tags
Full time, Temporary work, Apprenticeship, Work at office, Remote work, Work from home, Home office, Monday to Friday