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 RN license without restrictions in Puerto Rico and/or Active RN license in Florida, USA. Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico) IF you have an Active RN license in FL, USA, this is not a mandatory requirement Prior clinical experience in an acute care, skilled nursing, rehabilitation, OR discharge planning If you do not have an active FL RN license: You need to have 2 consecutive years of experience as RN of the preceding 3 years(no gaps in employment) and apply for FL RN license endorsement as soon as employment offer is accepted. OR, Preferred Qualifications Health Plan experience Previous Case Management Experience Call center or triage experience Previous experience managing Medicare members Additional Information Please submit resume in English Schedule: 8:00 AM - 6:00 PM (Adjust work schedule according to business hours, overtime and/or weekends) Training: on site Address: POP V, Tower 3, 7th floor, Oriental Bank Building. 997 San Roberto St. San Juan, PR 00926 Travel: N/A Language Proficiency Testing (English/Spanish): Any Humana associate who speaks with a member in a language other than Spanish and/or English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government Scheduled Weekly Hours 40 SDL2017
