The individual in this role will work as an Oklahoma-based, primarily telephonic care manager. This care manager will assess and evaluate enrollees' needs and requirements to achieve or maintain optimal wellness. The care manager will guide enrollees/families towards and facilitate interaction with appropriate resources for their care and wellbeing. The Care Manager, Telephonic Nurse 2 work assignments are varied but will focus on those enrollees with a primary physical health diagnosis. This role requires interpretation and independent determination of appropriate actions and may require home or facility-based visits to enhance enrollee engagement and services. You will work in collaboration with the interdisciplinary care management team. This team includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants. We design this team-based approach to ensure enrollees receive holistic person-centered care management. The Care Manager, Telephonic Nurse 2 will utilize clinical expertise and experience to determine when face-to-face enrollee support is required. They will engage the appropriate members of the care management team and/or coordinate in-person meetings between the care manager and the enrollee. The Care Manager, Telephonic Physical Health Nurse, Responsibilities include: - Employs a variety of strategies, approaches, and techniques to manage an Enrollee’s behavioral, physical, environmental, and psycho-social health needs. - Ensures Enrollees are progressing toward desired outcomes by continuously monitoring their assessments and evaluations. - Identifies and resolves barriers that hinder effective care and ensures through continuous monitoring of assessments and evaluations that the Enrollee is progressing toward desired outcomes. - Creates Enrollee care plans, and understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. - Makes decisions about their own work methods, occasionally in ambiguous situations, and requires minimal direction, receiving guidance where needed. - Performs telephonic and face to face assessments and evaluations of the member’s needs and requirements to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member. - Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations. - Creates member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. - Collaborates with providers and community services to promote quality and cost-effective outcomes. - Follows established guidelines/procedures. - Possible travel to Humana Oklahoma office for meetings and training Required Qualifications - Must reside in Oklahoma. - Active Registered Nurse (RN) license, Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW) - Minimum 1-year clinical experience. - 2 or more years of care management. - Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs or benefits. - Knowledge of community health and social service agencies and additional community resources. - Exceptional communication and interpersonal skills with the ability to quickly build rapport. - Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint. Preferred Qualifications - Case Management Certification (CMC). - Bilingual Spanish Speaking Additional Information 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 recommended; wireless, wired cable or DSL connection is suggested. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - 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. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: - Health benefits effective day 1 - Paid time off, holidays, volunteer time and jury duty pay - Recognition pay - 401(k) retirement savings plan with employer match - Tuition assistance - Scholarships for eligible dependents - Parental and caregiver leave - Employee charity matching program - Network Resource Groups (NRGs) - Career development opportunities HireVue 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. SSN Alert Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [redacted] with instructions on how to add the information into your official application on Humana's secure website. 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.