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Hours Full-time, Part-time
Location Louisville, Kentucky

About this job

Role: Health Planning and Support RN

Assignment: Telephonic nurse

Location: Work-at-home (10:30 - 7:00 EST)

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 the clinical world -- Engage Humana members with health and well-being advice.

Humana is seeking a Health Planning and Support (HPS) nurse to provide Humana members with general nurse advice; accepting inbound phone calls from members seeking assistance with medical questions. Nurses are trained to act as a clinical concierge, guiding members to resources, programs and/or healthcare providers for assistance with managing chronic conditions or medical advice. The HPS nurse assesses and identifies specialty program eligibility for members with increasing need for personal health guidance. HPS Nurses will also place outbound calls to members for education and counseling on the importance of preventive screenings and treatment or medication adherence.

Key Competencies

Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.

Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.

Is Accountable: You meet clearly stated expectations and take responsibility for achieving results.

Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs

Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience. Role Essentials

Active unrestricted RN in the state(s) in which the nurse is required to practice

Active Registered Nurse license with multi-state privileges from one of the following Nurse Licensure Compact (NLC) states: Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin

Three to five years of clinical experience; preferably in an acute care, skilled or rehabilitation clinical setting

Ability to obtain multi-state licensure

Previous insurance experience or workers comp experience

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 or related healthcare field

Previous experience in call center are preferable

Ability to work independently under general instructions and with a team

Knowledge of Humana systems is a plus.

Previous case management, utilization review, or triage experience

Bilingual is a plus

Additional Information:

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.