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Hours Full-time, Part-time
Location Saint Petersburg, Florida

About this job

Role: Humana At Home Care Manager - Care Plus

Assignment: Humana At Home

Location: Within driving distance of the St Petersburg, FL office

Humana’s dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor. Humana’s Perfect Service® means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members. We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares.

Assignment Capsule

Be a part of our Clinical Space –engage our members and guide them to develop lifelong wellbeing and health.

Humana is seeking a Humana At Home Manager to telephonically assess Medicare, Commercial and Group Account members in 7 domains of functioning; evaluate member needs and requirements to achieve and/or maintain optimal wellness state. You will guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. Work in collaboration with a multi-disciplinary team, employing a variety of strategies, approaches and techniques to manage a member’s physical, environmental and psycho-social health issues.

Other responsibilities include:

Proactive telephonic outreach to eligible Humana members and engage participation in Humana At Home Complex Care Management program.

Actively participate in all enrollment activities.

Complete physical, psychological, emotional and environmental assessments, for the purpose of providing appropriate, timely interventions to ensure provision of optimal care.

Coordinate community care and services as deemed appropriate.

Works Collaboratively with other members of the Humana At Home Interdisciplinary team-to include; Humana At Home Care Managers-Social Services, Field Care Managers and Community Health Educators.

Understand clinical program design, implementation, and management, monitoring and reporting.

Comply with performance and reporting standards as defined by Humana Corporation.

Additional responsibilities as deemed appropriate by Humana At Home leadership.

Key Competencies

Accountability – Meets established expectations and takes responsibility for achieving results; encourages others to do the same. Employs focus, attention to detail, reliability, and appropriate prioritization to drive outcomes. Sees opportunities to contribute and takes the initiative to create solutions.

Builds Trust – C onsistently models and inspires high levels of integrity in decisions, speech, and actions. Lives up to commitments, taking responsibility for the impact of one’s actions. Exercises the courage to prioritize principles and values over personal or professional gain.

Customer Focus – Connects meaningfully with customers to build emotional engagement and customer advocacy. Develops and applies deep customer knowledge and intimacy to develop and deliver products, services, and interactions that provide value beyond expectations. Simplifies complexity and integrates internal efforts to deliver an optimal customer experience.

Executes for Results – E ffectively leverages resources to create exceptional outcomes. Determines the best course of action when facing ambiguity. Anticipates and constructively resolves barriers and constraints. Embraces change, applies new knowledge and reconfigures quickly to capitalize on opportunities. Role Essentials

Active Registered Nurse (R.N.) license in the State of Florida and possess the ability to be licensed as a registered nurse in multiple states without restrictions.

Bilingual – Creole, English

Seasoned professional nurse with 3 years of clinical nursing experience.

Exceptional communication and interpersonal skills.

Ability to interact effectively with multi-disciplinary team members.

Intermediate to advanced computer skills and experience with Microsoft word and excel.

Excellent keyboard and web navigation skills.

Ability to use a variety of electronic information applications/software programs.

Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work.

Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M

Ability to travel, work and train onsite plus additional travel as needed for ongoing training.

Ability to work a full-time (40 hours minimum) flexible work schedule.

Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10-panel drug test

Role Desirables

Bachelor’s degree in Nursing (B.S.N.)

Previous telephonic case management experience working in the medical/insurance field.

Previous managed care experience.

Previous work with vulnerable adults or the geriatric population

Basic knowledge of complex care management and care management principles

Experience with motivational interviewing

Experience with behavior change, health promotion, coaching and wellness.

Reporting Relationships

You will be in the Humana At Home area under the direction of a Humana At Home Coach.

Additional Information

At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.

The following policy applies ONLY to associates working in the state of Arizona:

Humana is committed to providing a safe and healthy work environment and to promoting the health and well-being of its associates. Effective July 1, 2011, Humana has adopted a tobacco-free hiring policy that will promote a healthier workplace and will not hire users of tobacco and nicotine products. If you have any questions, please consult with your recruiter.