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We are seeking compassionate and motivated Registered Nurses to join our team in Puerto Rico as a RN Care Manager. This is a remote, Work-At-Home position, but you must live in Puerto Rico to be considered.
You will report directly to a Manager of Care Management and support our CarePlus and Humana members with chronic and complex health conditions through telephonic care management. You will build strong relationships with members through communication and engagement and use your clinical knowledge to assess and evaluate their needs to achieve or maintain an optimal wellness state. We are looking for bilingual RNs who are proficient in both Spanish and English. Succes in the role requires a strong knowledge of chronic condition management including treatment plans, pharmacological treatment, and signs and symptoms.
Please be advised, our screening and interview process is conducted entirely in English, and if selected for this position, you will be required to pass language proficiency tests in both English and Spanish before we can extend an offer.
The Care Manager, Telephonic Nurse employs a variety of strategies and techniques to manage a member's physical, environmental and psycho-social health issues. Responsibilities include the following:

• Identify and resolve barriers that hinder effective care.
• Ensure patient is progressing towards desired outcomes by managing patient care through assessments and evaluations.
• Monitor member progress and adjust care strategies to ensure optimal outcomes
• Assist in developing and implementing individualized care plans
• Collaborate with interdisciplinary teams to coordinate care and services
• Manage your daily tasks, maintain accurate documentation and follow established guidelines and procedures

Use your skills to make an impact
Required Qualifications

• Bachelor's Degree in Nursing (BSN)
• Bilingual in English and Spanish (and able to pass language proficiency tests in both languages)
• Active RN license without restrictions in Puerto Rico
• Active RN license without restrictions in Florida or licensure in another state and a passing score on the NCLEX exam.
• Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico).
• Prior clinical experience in adult acute care, skilled nursing, rehabilitation or discharge planning
• Knowledge in Chronic Condition management (treatment, pharmacological treatment, signs and symptoms), including Diabetes, Hypertension, COPD, and chronic kidney disease.
• Shift is 8-hours, plus 1 hour for lunch, from 8:30 AM to 5:30 PM EST and we adjust for Daylight Savings.
• We adjust the work schedule according to business needs including necessary overtime and weekends.

Preferred Qualifications

• Health Plan experience
• Previous Case Management Experience
• Call center or triage experience
• 1+ years of experience managing Medicare members

Language Proficiency Testing
Any Humana associate who speaks with a member in a language other than Spanish must take a language proficiency assessment, provided by an outside vendor, to ensure competency. The Federal Government requires applicants to take the Interagency Language Rating (ILR) test.
Additional Information
As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring process. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule.
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.
$56,900 - $78,200 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 at Humana.com and at CenterWell.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.