Care Manager, Telephonic Nurse

Humana Inc; Columbia (SC); Remote; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Disability and life insurance

Job summary

Humana Inc. is seeking a Telephonic Nurse 2 Care Manager to assess and coordinate care for members via phone. The role requires SC RN licensure with multi-state privileges, clinical experience, and strong documentation skills.

You will collaborate with families, providers, and interdisciplinary teams to support optimal wellness outcomes. This remote position may require up to 20% travel for outreach and meetings, with standard business hours and occasional scheduling flexibility.

Qualifications

• Active, unrestricted RN license in South Carolina with multistate compact privileges
• Must reside in South Carolina
• 3+ years of recent acute care nursing experience
• Experience providing education for chronic condition management
• Experience with community resource coordination
• Proficiency with Microsoft Office applications (Word, Excel, Outlook)
• Strong documentation and multitasking capabilities

Responsibilities

• Conduct telephonic assessments of members' clinical, behavioral, social, and environmental needs
• Identify and resolve barriers to care or treatment adherence
• Develop and update individualized care plans
• Monitor progress toward outcomes through ongoing assessment
• Provide education and support for chronic condition management
• Coordinate care and access to providers and community resources
• Collaborate with families, providers, and interdisciplinary teams
• Maintain documentation in line with guidelines and compliance
• Apply policies and objectives to daily work
• Exercise independent judgment with limited direction
• Travel up to 20% as needed

Skills

RN licensure SC

Multistate compact

Care coordination

Documentation

MS Office

Education

BSN (preferred)

Tools

MS Office (Word/Excel/Outlook)

Job description

Become a part of our caring community

The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements. This is done to achieve and/or maintain optimal wellness state. The Care Manager guides members/families toward and facilitates 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.

You will report to the Manager, Care Management

Responsibilities:

• Conducts telephonic assessments to identify members’ clinical, behavioral, social, and environmental needs.

• Identifies and resolves barriers that hinder effective care or treatment adherence.

• Develops, implements, and updates individualized care plans, as appropriate.

• Monitors member progress toward desired outcomes through ongoing assessment and evaluation.

• Provides education and support for chronic conditions management and self-care.

• Coordinates care and facilitates access to appropriate providers, services, and community resources.

• Collaborates with members, families, providers, and interdisciplinary teams to support care goals.

• Maintains timely and accurate documentation in accordance with established guidelines and quality and compliance requirements.

• Applies department, segment, and organizational policies, procedures and operational objectives in day to day work to support established strategy and operating objectives.

• Exercises independent judgment and utilizes available resources in managing assigned caseloads, occasionally in ambiguous situations, with minimal direction and guidance.

• Up to 20% travel may be required due to business needs, including member outreach and meetings.

In this role, you will have the opportunity to make a meaningful impact by supporting members through care coordination, education, and resource connection that improves health outcomes and quality of life.

This position primarily works standard business hours; however, schedule flexibility may be required based on business needs.

Use your skills to make an impact

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in the state of South Carolina with multistate compact privileges and no disciplinary action

• Must reside in the state of South Carolina

• 3+ years of recent acute care clinical nursing experience

• Experience providing education and support for chronic condition management

• Experience with community resource coordination

• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook

• Strong documentation, multitasking, and computer navigation with basic troubleshooting skills

Preferred Qualifications

• Bachelor of Science in Nursing (BSN)

• Experience in telephonic case management, care management, discharge planning, transitions of care and patient education in an adult acute care setting

• Managed care experience

• Medicare & Medicaid population experience

• Behavioral health management awareness

• Telephonic nursing experience

• Certified Case Manager (CCM)

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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.