Bilingual RN Care Manager

apartment Humana location_onSan Juan, San Juan 00918, PR

$56,900 - $78,200 / YEAR

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

This is a remote, telephonic position, but you must live in Puerto Rico. The RN Care Manager uses clinical knowledge to assess and evaluate members' needs to achieve and maintain optimal wellness. They also guide members with chronic conditions toward and facilitate interaction with resources appropriate for their care and wellbeing. The Care Manager reports to a Manager of Care Management, and work assignments frequently require interpretation and independent determination of the appropriate courses of action. We require you to be bilingual in English/Spanish and will test you for both languages - Speaking/Reading/Writing included. Please submit your resume in English.

The Care Manager, Telephonic Nurse employs a variety of strategies and techniques to manage a member's physical, environmental and psycho-social health issues. Responsibilities include the following:

Resolve barriers that hinder care.
Ensure patient is progressing towards desired outcomes by managing patient care through assessments and evaluations.
May create member care plans.
Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.
Require minimal direction and receive guidance where needed. Follow established guidelines/procedures.

Use your skills to make an impact

Required Qualifications

Bachelor's Degree in Nursing (BSN)
Bilingual in English and Spanish (and able to pass language proficiency tests in both languages)
Active RN license without restrictions in Puerto Rico
Active RN license without restrictions in Florida or licensure in another state and a passing score on the NCLEX exam.
Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico).
Prior clinical experience in adult acute care, skilled nursing, rehabilitation or discharge planning
Knowledge in Chronic Condition management (treatment, pharmacological treatment, signs and symptoms), including Diabetes, Hypertension, COPD, and chronic kidney disease.
Shift is 8-hours, plus 1 hour for lunch, from 8:30 AM to 5:30 PM EST and we adjust for Daylight Savings.
We adjust the work schedule according to business needs including necessary overtime and weekends.

Preferred Qualifications

Health Plan experience
Previous Case Management Experience
Call center or triage experience
Previous experience managing Medicare members

Work-At-Home Requirements

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 suggested.
Satellite, cellular and microwave connection can only be used if leadership approves it.
Humana will provide Work-At-Home employees with telephone equipment appropriate to meet the requirements for their position.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Language Proficiency Testing

Any Humana associate who speaks with a member in a language other than Spanish must take a language proficiency assessment, provided by an outside vendor, to ensure competency. The Federal Government requires applicants to take the Interagency Language Rating (ILR) test.

Additional Information

As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring process. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule.

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

Scheduled Weekly Hours

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.

$56,900 - $78,200 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.

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Humana's Driver Safety Program 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. Preferred Qualifications Bachelor of Science in Nursing (BSN). 2+ years of experience of in-home case/care management Experience with Medicare/Medicaid members. Experience with health promotion, coaching, and wellness. Previous managed care experience. Bilingual — English, Spanish. Certification in Case Management. Motivational Interviewing Certification and/or knowledge in area. Additional Information Workstyle/Travel: This is a Hybrid – Home position that requires occasional onsite work at the market office in Schaumburg, Illinois, as well 75-90% travel in the field to visit members Work Schedule : Monday - Friday; 8am - 5pm CST Work at Home Requirements At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Associates 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 associates 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. Interview Format As part of our hiring process, we will be using interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. 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. $78,200 - $107,600 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.

Full-time

Field Care Manager - RN

apartment Humana location_onSchaumburg, IL

$78,200 - $107,600 / YEAR

Become a part of our caring community and help us put health first The Field Care Manager Registered Nurse (RN) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members and families toward resources appropriate for the care and wellbeing of members. The Field Care Manager Nurse employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. The Field Care Manager Registered Nurse key roles and responsibilities may include the following: Identifies and resolves barriers that hinder effective care. Ensures member is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. Create plans of care. Communicates with internal and external stakeholders. 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), requires minimal direction, and receives guidance where needed. Follows established guidelines/procedures. Visits Medicaid members in their homes, Supportive Living Facilities, and/or Long-Term Care Facilities and other care settings – 75-90% local travel (see Additional Information section). Use your skills to make an impact Required Qualifications Applicants must reside in Edgar, Iroquois, Kankakee, or Vermilion County, IL, within one of the following ZIP codes, or within a 10-mile radius of these Zip Codes: 60901, 60910, 60911, 60912, 60913, 60914, 60915, 60917, 60918, 60922, 60924, 60926, 60927, 60928, 60930, 60931, 60932, 60935, 60938, 60939, 60940, 60941, 60942, 60944, 60945, 60948, 60950, 60951, 60953, 60954, 60955, 60956, 60958, 60960, 60961, 60963, 60964, 60966, 60967, 60968, 60969, 60970, 60973, 60974, 61810, 61811, 61812, 61814, 61817, 61831, 61832, 61833, 61834, 61841, 61844, 61846, 61848, 61850, 61857, 61858, 61865, 61870, 61876, 61883, 61917, 61924, 61932, 61933, 61940, 61944, 61949, 61955. Registered Nurse (RN) in the state of Illinois without disciplinary action. Clinical nursing experience required (hospital, acute care, or home health Ability to travel 75-90% within the state of Illinois 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. Humana's Tuberculosis (TB) screening Program This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Humana's Driver Safety Program 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. Preferred Qualifications Bachelor of Science in Nursing (BSN). 2+ years of experience of in-home case/care management Experience with Medicare/Medicaid members. Experience with health promotion, coaching, and wellness. Previous managed care experience. Bilingual — English, Spanish. Certification in Case Management. Motivational Interviewing Certification and/or knowledge in area. Additional Information Workstyle/Travel: This is a Hybrid – Home position that requires occasional onsite work at the market office in Schaumburg, Illinois, as well 75-90% travel in the field to visit members Work Schedule : Monday - Friday; 8am - 5pm CST Work at Home Requirements At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Associates 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 associates 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. Interview Format As part of our hiring process, we will be using interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. 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. $78,200 - $107,600 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.