2025-04-15

Job Description:

The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members’ needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.

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Job Responsibilities:

• Coordinate community care and services as deemed appropriate.
• Understand clinical program design, implementation, and management, monitoring and reporting.
• Provide guidance and clinical expertise on how to navigate through the health care setting.
• Provide ongoing consultation with your patients via telephone to ensure that they are receiving the best quality of care possible.
• Consult with your patients on how to ask the right questions and interpret complex medical content in an effort to enhance the member experience.
• Comply with performance and reporting standards as defined by Humana.
• Apply your clinical knowledge to educate and empower your members, to take charge of their own healthcare decisions.

Job Requirements:

• Ability to be licensed as a registered nurse in multiple states without restrictions.
• Strong computer, web navigation and research skills.
• Prior Managed Care experience
• Bachelor’s degree in Nursing (B.S.N)
• Must be licensed and reside in an eNLC state
• Ability to work independently under general instructions and with a team.
• 3 – 5 years of clinical acute care experience
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
• Certified Case Manager (CCM)
• Call center or telephonic triage experience
• Bilingual in Spanish is highly desired
• Highly desired clinician with both physical and behavioral health background
• Exceptional communication and interpersonal skills.

Job Details:

Company: Humana

Vacancy Type: Full Time

Job Location: Louisville, KY, US

Application Deadline: N/A

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