Care Manager, Telephonic Nurse (Disease Management)

Become a part of our caring community and help us put health first
 Humana Healthy Horizons in Virginia is seeking a Care Manager, Telephonic Nurse 2 (Disease Management) who will assess and evaluate member’s needs with emphasis on preventing, monitoring, and managing chronic conditions effectively, in a telephonic environment. This position assists members with their health care needs and obtain the right services, skills, and supports needed to achieve optimal health and life functioning in the community.

• Strengthens care management activities and support the improvement of member well-being, reducing unnecessary healthcare costs and enhancing healthcare delivery. 
• Provides episodic care coordination that is short term (e.g., up to 12 weeks, based on member need) focusing on education and support to enhance lifestyle modifications and self-management techniques.    
• Coordinates with Care Managers and other identified care team members as needed along with UM staff, physicians and providers as necessary and arrange services necessary to address the member’s condition and current needs. 
• Assesses, monitors, and evaluates member’s chronic condition as well as provide and document meaningful interventions and outcomes.
• May contribute to interdisciplinary care planning and meetings.
• Meet requirements for contractual and regulatory compliance.
• Follows established guidelines/procedures.
• Other duties as required.                                          

Use your skills to make an impact
 

Required Qualifications

• Must reside in the Commonwealth of Virginia or within a 40-mile radius from Virginia in a bordering state/district (Washington DC, MD, WV, KY, TN & NC).
• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
• Three (3) years clinical RN experience including educating members/patients on chronic conditions.
• Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
• Knowledge of community health and social service agencies and additional community resources.
• Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport.
• Ability to work with minimal supervision within the role and scope.
• Ability to use a variety of electronic information applications/software programs including electronic medical records.
• Excellent keyboard and web navigation skills.

​

Preferred Qualifications

• Bachelor's degree in nursing (BSN).
• Case Management Certification (CCM).
• Managed Care experience.
• Certified Diabetes Educator.
• Certified Asthma Educator.
• Motivational Interviewing Certification and/or knowledge.
• Experience with health promotion, coaching and wellness.
• Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. See "Additional Information" section for additional information.

Additional Information

• Workstyle: This is a remote position.
• Travel: You may be required to travel to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings.
• Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
• Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English 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.

WAH Internet Statement

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.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

Apply