Humana Care Manager Telephonic Nurse 2 in Boston, Massachusetts
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.
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.
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
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)
Scheduled Weekly Hours
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