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Job Information

Humana Care Manager, Bilingual English/Creole Telephonic Nurse 2 - Palm Beach, FL in North Palm Beach, Florida

Description

The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate 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.

Responsibilities

The Care Manager, Telephonic Nurse 2

  • Employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.

  • 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

  • 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.

  • Monday - Friday 10:30am-7pm

Required Qualifications

  • 5+ years of clinical OB Maternity and Women's Health care experience

  • Licensed Registered Nurse (RN) in the Florida with no disciplinary action

  • Bilingual English/Creole speaker with ability to pass Language Assessment

  • Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Experience with case management, discharge planning and patient education for adult acute care

  • Knowledge of Milliman or Interqual

  • Managed care experience

  • Certified Case Manager (CCM)

Scheduled Weekly Hours

40

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