Remote RN Care Manager: Telephonic Case Coordination

Humana Inc; Trenton (NJ); Remote; USD 71,000 - 98,000; Full time

Job summary

Humana Inc. is seeking a remote Telephonic Care Manager to deliver holistic case management across the continuum of care, aiming to prevent hospital readmissions and promote appropriate utilization of funding sources.

You will coordinate with CM programs, MTF staff, and providers to create integrated care plans addressing beneficiary needs and conditions, while meeting security requirements and shift hours.

Qualifications

• Citizenship per Department of Defense contract – U.S.
• Interim approval for NBIS security clearance required
• HGB cannot hire in Puerto Rico due to government contract
• Active RN license in state of employment
• CCM certification must be obtained within 1 year of hire
• 2 years of case management experience
• 3 years of clinical RN or managed care RN experience
• Must work Mon–Fri, 8:00 a.m.–5:00 p.m. or 9:00 a.m.–6:00 p.m. ET

Responsibilities

• Provide comprehensive, holistic case management across the continuum of care.
• Coordinate with Care Management programs, MTF Utilization Management/Case Management/CM staff, and providers to ensure an integrated care plan addressing beneficiary needs and conditions.
• Serve as the point of contact for beneficiaries for activities within the clinical spectrum.

Skills

RN license

CCM certification

Case management

Managed care RN experience

Interim security clearance

Education

Bachelor's degree in nursing

Job description

Humana Inc. is seeking a remote Telephonic Care Manager to deliver holistic case management across the continuum of care, aiming to prevent hospital readmissions and promote appropriate utilization of funding sources.

You will coordinate with CM programs, MTF staff, and providers to create integrated care plans addressing beneficiary needs and conditions, while meeting security requirements and shift hours.