Job Description

Become a part of our caring community and help us put health first

The Compact licensed telephonic Care Manager works from home in a call center environment.


They assess and evaluate members' needs and requirements to achieve or maintain optimal wellness by providing care coordination and facilitating member or family interaction with resources appropriate for the care and wellbeing of the member.

Job Description

Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management services are centered on the person rather than the condition. The Care Manager uses a range of strategies and techniques to manage a member's physical, environmental, and psycho-social health issues. They identify and resolve barriers to effective care and continuously monitor progress through assessments and evaluations to ensure members achieve their desired health outcomes.

Role Overview

• The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system.
• This role operates in a fast-paced environment, requiring the ability to quickly engage with members while navigating multiple computer applications simultaneously. To maintain compliance and support the auto-dialer process critical to our operations, care managers follow structured daily schedules, which limits day-to-day flexibility .
• All our RN Care Managers are work at home associates, working from a dedicated home office space (see Work at Home Guidance below).
• Remote Care Managers are expected to achieve established outcomes, quality, and productivity benchmarks and demonstrate advanced communication and interpersonal skills.

Duties Include

• Telephonically working with Medicare members with transitional needs and complex chronic conditions.
• Assessing members’ physical, environmental, and psychosocial health needs, collaborating with a multidisciplinary team, and implementing timely clinical interventions to manage risks, coordinate care, and help prevent avoidable hospitalizations.
• Collaboration with members who face multiple chronic conditions, along with financial and functional challenges, to support them in achieving and sustaining optimal health.
• May develop individualized member care plans.

Success in this position requires that you

• Understand department, segment, and organizational strategies and objectives, and how they connect to related areas.
• Exercise judgement regarding own work methods, even in ambiguous situations, with minimal direction and occasional guidance where needed.
• Demonstrate flexibility and ability to promptly adapt to new processes and workflows.
• Adhere to established guidelines/procedures.

Use your skills to make an impact

Required Qualifications

• Active Registered Nurse (R.N.) license with no disciplinary action on any license.
• Must hold an active Compact nursing license and reside in the state that holds your compact license.
• 3+ years of clinical acute care experience with case management, discharge planning, and patient education for adult acute care
• Demonstrated clinical expertise in managing chronic conditions through individualized care planning, supported by strong assessment and critical thinking skills
• Proficiency in Microsoft Office applications including Word, Excel, and Outlook.
• Demonstrated proficiency in navigating multiple systems using dual monitors, with strong computer skills and the ability to quickly learn new applications. Skilled in autonomous decision-making, troubleshooting, and problem-solving system-related issues

Preferred Qualifications

• BSN or MSN degree
• Case Management experience
• Managed care experience
• Certified Case Manager (CCM)
• Bilingual in English and Spanish (see Language Proficiency Testing below)

Training and Work Schedule

• The first 4 weeks of training work hours will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training.
• Following training, work hours are:
  • If you live in the Eastern Time Zone (EST): Work hours are 9:00 AM to 5:30 PM EST.
  • If you live in the Central Time Zone (CST): work hours are 8:00 AM to 4:30 PM CST, which corresponds to 9:00 AM to 5:30 PM EST.

Work at Home Guidance

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is also required. Satellite, cellular and microwave connection is not allowed.
• On occasion, the personal level of internet service a Home or Hybrid Home/Office associate provides—despite meeting the minimum requirement above—proves to be insufficient to maintain an optimal connection through Humana's VPN and thereby interferes with the Home or Hybrid Home/Office associate's ability to work effectively. When this happens, Humana reserves the right to require the associate to upgrade the level of his/her personal internet service as a condition of employment. Based on system requirements, you may need a download speed of up to 200 Mbps and an upload speed of 20 Mbps.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Language Proficiency Testing

Any Humana associate who wishes to communicate with members in a language other than English must complete a language proficiency assessment, administered by an approved external vendor, to ensure fluency and competency in that language Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Please note during the screening process, you will be asked to provide your Compact Nursing license number and your internet upload and download speeds from . These items will be required prior to scheduling an interview.

Social Security Task

Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$71,100 - $97,800 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Job Tags

Bi-weekly pay, Full time, Temporary work, Apprenticeship, Live in, Work at office, Remote work, Home office,

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