Care Manager, Telephonic Nurse

This is a fully remote position, open to applicants in Oklahoma.

📋 Description

• Evaluate and assess the needs and requirements of enrollees to ensure optimal wellness is achieved or maintained.

• Provide guidance to enrollees and their families in accessing suitable care and wellbeing resources.

• Oversee the behavioral, physical, environmental, and psycho-social health needs of enrollees.

• Monitor assessments and evaluations to confirm progress towards desired health outcomes.

• Identify and address obstacles to effective care delivery.

• Develop care plans for enrollees/members.

• Conduct both telephonic and face-to-face assessments and evaluations.

• Collaborate with providers and community services to enhance quality and cost-effective outcomes.

• Work alongside an interdisciplinary care management team, which includes community health workers, housing support specialists, SDOH coordinators, and care management support assistants.

• Assess the necessity for in-person enrollee support and organize face-to-face meetings accordingly.

• Adhere to established guidelines and procedures.

• Occasionally travel to Humana Oklahoma offices for meetings, training, or other business-related activities.

⛳️ Requirements

• Must be a resident of Oklahoma.

• Current Registered Nurse (RN) license, Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW) is required.

• At least 1 year of clinical experience is necessary.

• A minimum of 2 years in care management experience.

• Experience in coordinating services, care needs, or benefits for Medicaid and/or Medicare enrollees.

• Familiarity with community health and social service agencies, along with additional community resources.

• Proficient knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.

• Case Management Certification is preferred.

• Bilingual skills in Spanish are preferred.

• Minimum home internet speed of 25 Mbps download and 10 Mbps upload is required.

• A dedicated workspace free from interruptions to safeguard member PHI / HIPAA information is essential.

🏝️ Benefits

• Bonus incentive plan based on both company and individual performance.

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance benefits.

• Flexible work arrangements, including home or hybrid home/office options.

• Requirements for dedicated workspace and internet service for remote work.