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  • WORK FROM HOME!

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CCM – Personal Registered Nurse – RN – Case Manager – Work At Home

Humana • WORK FROM HOME!

Posted 8 days ago

Job Snapshot

Full-Time
Competitive Salary plus Benefits Package
Healthcare - Health Services, Managed Care, Insurance
Nurse, Health Care, Insurance
61

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Job Description

CCM – Personal Registered Nurse – RN – Case Manager – Work At Home

Attention Registered Nurses! Would you enjoy an opportunity to Work at Home? Humana wants YOU to join our growing team of Personal Registered Nurses. We have multiple openings for Personal RN’s – Apply today!

Humana is a Fortune 100 Company that has received notable awards for our products, services, and commitment to our members. Humana is seeking multiple CCM’s (Certified Case Managers) who will engage our members to develop lifelong well-being and health.

As a CCM – Personal Registered Nurse - Case Manager, you will be a member of our Integrated Care Team (ICT) encompassing Case Management, Disease Management, and the Personal Nurse program.  You will provide a comprehensive, holistic approach through care management for TRICARE beneficiaries.  You will be the primary coordinator and point of contact for all activities within the medical spectrum; including managing case management and disease management conditions and cases.

Our Department of Defense Contract requires U.S. citizenship for this position.

CCM – Personal Registered Nurse – RN – Case Manager Responsibilities:

  • Utilize applicable sources of information to identify, assess, and enroll patients eligible for the chronic care management program.  Contact enrolled beneficiaries via outbound calls to further assess and intervene per the chronic care management protocols.  Update the Care Management System per HGB Medical Affairs policies and procedures; complete all reporting requirements in a timely manner, and direct administrative staff to complete all mailings within specified timeframes.

 

  • Assess, plan, coordinate, implement, monitor, and evaluate the care of each beneficiary under the Personal Nurse / ICT purview across the continuum of care.  Develop a cost effective treatment plan that is acceptable to both the beneficiary (patient) and physician utilizing both evidence based medical information, DoD and community resources.  Plan shall include psychosocial issues, home environment and behavioral health needs across the full continuum of care.  Maintain beneficiary’s privacy, confidentiality and safety, advocacy, adherence to ethical, legal, and accreditation/regulatory standards during this process.

 

 

  • Place outbound calls to identified beneficiaries within 3 work days of notification hospital discharge to assess for discharge needs, family support, depression status, DME needs, and encourage compliance with discharge instructions and record responses in the Care Management System 

 

  • Review and coordinate home infusion referrals with Tpharm contactor, infusion /home health, DME providers to ensure beneficiaries receive timely infusion services to address identified medical conditions.

 

  • Coordinate and collaborate with members of the ICT or other external programs to ensure a fully integrated care plan addressing all beneficiary needs and conditions; documenting all interventions and outcomes for beneficiaries in the Personal Nurse program and ICT team.

Job Requirements

CCM – Personal Registered Nurse – RN – Case Manager Job Requirements:

  • Registered Nurse with current in state RN license

  • Case Management Certification (CCM) [Note: This is also a requirement by date of hire for any Humana Inc. internals.  However, If a current Humana Government Business associate, given until October 1, 2018 to obtain]

  • Minimum of three years’ clinical experience

  • Interqual (or Milliman) knowledge STRONGLY DESIRED

  • Bachelor’s Degree in Nursing STRONGLY DESIRED

  • Three (3) years’ experience in managed care environment STRONGLY DESIRED

     

Additional Requirements for Work from Home:

  • Must have accessibility to high speed DSL or cable modem internet (must be able to connect computer without using a wireless or satellite signal) and recommended speed for optimal performance from Humana At Home's systems if 10Mx1M.
  • Must have a separate room with a locked door that can be used as a home office.
  • Must have accessibility to high speed DSL or cable modem internet (must be able to connect computer without using a wireless or satellite signal)

Benefits

Humana provides tools and resources to help you make health and wellness decisions that work for you and your family.

 

  • Medical benefits/ Dental benefits

  • Healthcare spending account
  • Long-term care
  • Life insurance
  • 401(k) Savings Plan
  • Retirement Plan
  • Vacation/ Paid Holidays
  • Tuition Reimbursement

About Us:

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies.  At Humana, we are dedicated to ensuring that every business decision we make reflects our commitment to improving the health and well-being of our members, our associates, the communities we serve, and our planet.  Humana has received several awards for our products, services, and business practices.  Many of these awards recognize our commitment to providing guidance consumers can use to make healthcare and health benefits decisions with confidence.



We are an Equal Opportunity Employer.  Be Passionate About What You Do – Apply Today!



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