Care Manager Obstetrics Registered Nurse - Pensacola and Tallahassee FL

Profile

Description

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.

Responsibilities

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.

Required Qualifications:

Active Florida Registered Nurse License without restrictions

3 years in hospital acute care experience

2 years of experience of in obstetrics clinical to include working within the prenatal and postpartum population

Knowledge of community health and social service agencies and additional community resources

Exceptional communication and interpersonal skills with the ability to quickly build rapport

Ability to work with minimal supervision within the role and scope

Ability to use a variety of electronic information applications/software programs including electronic medical records

Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel

Excellent keyboard and web navigation skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Additional Qualifications:

Location:

Must be willing to work onsite and within a work at home environment.

Ability to travel to onsite location within 30 to 40 miles of Pensacola and Tallahassee, FL to nearest onsite hospital.

Travel: 30% annually

Hours:

Must be able to work 8:30-5:00 PM local time.

Transportation:

This role is a part of Humana's Driver Safety program and therefore requires and individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,00 limits.

Work at Home Requirements:

Must have a separate room with a locked door that can be used as a home office to ensure continuous privacy while you work while making inbound and outbound calls with members.

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 At Home systems if 5Mx1M

Additional Screening Requirements:

This role is considered patient facing and is part of Humana At Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Associates working in the State of Florida will need ACHA Level II Background clearance

Preferred Qualifications

Bachelor's degree, BSN

Prior care management, managed care or referrals processing experience

Experience with health promotion, coaching and wellness

Previous experience in utilization management, Interqual/Milliman

Prior experience with Medicare & Medicaid recipients

Previous experience with electronic case note documentation and experience with documenting in multiple computer applications/systems

Previous managed care experience

Certification in Case Management (CCM)

Motivational Interviewing Certification and/or knowledge

Knowledge of community health and social service agencies and additional community resources

Bilingual English/Spanish and/or Creole - Leader may request language proficiency assessment if desired

Additional Information

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Modern Hire Voice 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.

If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Modern Hire Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com