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Humana Care Manager Telephonic Nurse 2 in Boston, Massachusetts

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. The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

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. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

  • Minimum of Associates Degree in Nursing

  • 3 - 5 years of clinical acute care experience

  • Minimum of 3 year of post-degree Behavioral Health facility-based clinical experience

  • Licensed as a Registered Nurse (RN) with a Compact State license

  • Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Experience with case management, discharge planning and patient education for adult acute care

  • Knowledge of Milliman or Interqual

  • Managed care experience

  • Certified Case Manager (CCM)

Additional Information

Scheduled Weekly Hours

40

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