Responsibilities

Location: must reside in Puerto Rico for this role

The Care Manager, Telephonic Nurse 2 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 assessments and/or evaluations. May create member care plans. This is a telephonic nursing role where you will reach out to our members to assist them with their health.

• Apply your clinical knowledge to educate and empower your members, to take charge of their own healthcare decisions.

• Provide guidance and clinical expertise on how to navigate through the health care setting.

• Consult with your patients on how to ask the right questions and interpret complex medical content in an effort to enhance the member experience.

• Coordinate community care and services as deemed appropriate.

• Understand clinical program design, implementation, and management, monitoring and reporting.

• Comply with performance and reporting standards as defined by Humana.

Click here to learn about a "Day in the Life" of our remote RN Care Managers.

https://www.youtube.com/watch?v=pzAhfOMSbyA&feature=youtu.be

Role Essentials

• Active RN license without restrictions in Puerto Rico

• Associates degree in Nursing

• Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico)

• 3 years or more of clinical experience in an acute care, skilled nursing, rehabilitation, discharge planning OR related field

• If you do not have an active FL RN license: You need to have 2 consecutive years of experience as RN of the preceding 3 years (no gaps in employment) and apply for FL RN license endorsement as soon as employment offer is accepted

• Ability to work independently under minimum supervision and with a team

• Must be fluent in English and Spanish

• Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 25 MBS Downstream/ 10 MBS Up-Stream. A hard wired connection is required

• Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.

• Proficient typing and computer navigation skills.

• Able to work 8:00 AM - 6:30 PM (Adjust work schedule according to business hours, overtime, daylight savings time and/or weekends)

Role Desirables

• BSN degree

• Health Plan experience

• Previous adult chronic conditions care management

• Previous experience in care management

• Case management certification

• Previous Case Management Experience

• Call center or triage experience

• Previous experience managing Medicare members

Additional Information

***Please submit resume in English

Language Proficiency Testing

Any Humana associate who speaks with a member in a language other than Spanish must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Please note interview will be in English.

Scheduled Weekly Hours