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RN Telephonic Case Manager - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | tampa, Florida |
About this job
Role: RN Telephonic Case Manager
Assignment: Medicaid
Location: Tampa, FL
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 -- as a Clinical Advisor you will engage our members to develop lifelong wellbeing and health.
Humana is seeking a RN Telephonic Case Manager who will provide:
Case management and coordination of care of members enrolled in Humana's Medicaid HMO products by utilization of nursing skills to triage, assess, monitor, evaluate, instruct, intervene and document goals and outcomes.
Coordination of medical management efforts with other Humana departments including, but not limited to Medicaid Administration, Health Services Onsite Staff, Case/Disease Management, Quality Improvement, and Provider Relations.
Collaborate with Team Leader and Health Services Manager for data collection, reporting and Quality Improvement initiatives on clinical programs, including evaluating ongoing effectiveness and improvement opportunities. Role Essentials
Active RN license in the state(s) in which the nurse is required to practice
Ability to be licensed in multiple states without restrictions
Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
Ability to work independently under general instructions and with a team
Valid driver's license and/or dependable transportation necessary (variable by region)
Role Desirables
Education: BSN or Bachelor's degree in a related field
Health Plan experience
Previous Medicare/Medicaid Experience a plus
Call center or triage experience
Previous experience in utilization management, discharge planning and/or home health or rehab
Bilingual is a plus
Strong clinical background desired
Case Management experience preferred
Knowledge of MS Word, Excel and Outlook a plus
Additional Information
Humana is an organization with careers that change lives---including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
Assignment: Medicaid
Location: Tampa, FL
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 -- as a Clinical Advisor you will engage our members to develop lifelong wellbeing and health.
Humana is seeking a RN Telephonic Case Manager who will provide:
Case management and coordination of care of members enrolled in Humana's Medicaid HMO products by utilization of nursing skills to triage, assess, monitor, evaluate, instruct, intervene and document goals and outcomes.
Coordination of medical management efforts with other Humana departments including, but not limited to Medicaid Administration, Health Services Onsite Staff, Case/Disease Management, Quality Improvement, and Provider Relations.
Collaborate with Team Leader and Health Services Manager for data collection, reporting and Quality Improvement initiatives on clinical programs, including evaluating ongoing effectiveness and improvement opportunities. Role Essentials
Active RN license in the state(s) in which the nurse is required to practice
Ability to be licensed in multiple states without restrictions
Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
Ability to work independently under general instructions and with a team
Valid driver's license and/or dependable transportation necessary (variable by region)
Role Desirables
Education: BSN or Bachelor's degree in a related field
Health Plan experience
Previous Medicare/Medicaid Experience a plus
Call center or triage experience
Previous experience in utilization management, discharge planning and/or home health or rehab
Bilingual is a plus
Strong clinical background desired
Case Management experience preferred
Knowledge of MS Word, Excel and Outlook a plus
Additional Information
Humana is an organization with careers that change lives---including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
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