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RN Care Manager, Telephonic Nurse (Bilingual)

Humana

Humana

This job is no longer accepting applications

See open jobs at Humana.
Customer Service
Remote · Puerto Rico
Posted on Friday, September 22, 2023

Description

This is a Work-At-Home position located in Puerto Rico.
You must be fully bilingual in English/Spanish and will be required to pass a test for both languages - Speaking/Reading/Writing included.
***Please submit resume in English.

The Care Manager, Telephonic Nurse works in a telephonic environment. They assess and evaluate members' needs and requirements to achieve and/or maintain an optimal wellness state, using clinical knowledge to manage chronic conditions in the adult population. The Care Manager advises and guides senior Medicare Advantage members and facilitates interaction with resources appropriate for their care and wellbeing.

Responsibilities

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

  • 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.

#LI-remote

This is a Remote opportunity

Required Qualifications

  • Registered Nurse from an accredited institution who have actively practiced nursing in a state, jurisdiction or territory of the US for 2 of the preceding 3 years without having license acted against by the licensing authority of any jurisdiction.

  • 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).

  • Prior clinical experience in adult acute care, skilled nursing, rehabilitation, OR discharge planning.

  • Must be fully bilingual in English/Spanish and will be required to pass a test for both languages - Speaking/Reading/Writing.

  • 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,

  • If you have under 2 yrs. experience as RN and have attended to one of the accredited schools in PR, must successfully complete and pass the NCLEX exam within 60 days of employment.

  • Ability to work independently under minimum supervision and with a team.

  • Able to work 8-hour shifts between 8:00 AM - 6:00 PM (Work schedule can be adjusted according to business hours, necessary overtime and/or weekends)

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

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. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Scheduled Weekly Hours

40

This job is no longer accepting applications

See open jobs at Humana.