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Case Manager, RN - Houston
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Case Manager, RN - Houston; | Humana ; | Houston TX 77056 USA; | Full Time .
Requirements; | Details; | Locations; | Contact .
Job Description: .
Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded health benefits companies, with approximately 9 million medical members. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals. Over its 45-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.
Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.
Minimum Requirements: Registered Nurse. Currently holds a valid nursing license with out restrictions in their designated location; ability to receive multi-state licensure as needed. Associate Degree in Nursing, Management or Health Related Field. At least 5 years of clinical experience in an acute clinical medical setting. Previous experience in case management, utilization management or discharge planning. CCM (Certified Case Manager) certification or eligibility desired. Bilingual desired. The Commercial Case Management Clinical Advisor supports Humana members by identifying and utilizing appropriate healthcare resources most consistent with the members' needs and by providing guidance along the healthcare continuum. The clinical advisor works with identified health plan members to assess their care needs, assist in coordinating interventions and services to meet those needs, and communicating with members, providers and Humana associates to promote efficient use of the healthcare system. The clinical advisor utilizes knowledge of benefit plan design and care alternatives available within the community and nationally in order to recommend services that represent the delivery of appropriate health care services for Humana Plan members as ordered by the member's care provider(s). This work may require frequent onsite visits to hospitals and/or other healthcare facilities and the ability to work via cable or DSL modem from home in a secure environment where confidentiality of member and company information can be maintained. Core Competencies Communication: The clinical advisor identifies and understands the needs and perspectives of others. He/she understands the audience and tailors delivery accordingly; shares information appropriately. The clinical advisor presents information and/or recommendations verbally, graphically and/or in writing that is articulate and succinct. Problem Solving: The clinical advisor proactively identifies and evaluates problems. He/she identifies appropriate subject matter experts and other information resources to resolve problems. The clinical advisor is able to collect, analyze and draw conclusions from information and is able to differentiate between symptoms and root cause - effectively handles resolution or hand-off of both components. Implementation/Execution: The clinical advisor effectively leverages available resources (financial, people, time) to accomplish objectives and maximize return on investment. He/she makes appropriate decisions in the face of ambiguity. Anticipates and resolves barriers and constraints. Technology: The clinical advisor chooses and adeptly uses appropriate technology tools, methodologies and solutions. From the telephone to the computer, the clinical advisor is at home with electronic technology and uses it as a matter of course. The Internet is a familiar place where the clinical advisor is able to navigate and find resources, information and tools to help guide members. The clinical advisor is able to learn via the internet and within a virtual environment. This position is a combination of work at home and onsite work. .
Job Requirements: .
See Above .
Job Details: .
Categories: Healthcare .
Travel Required: 25% of the time .
Preferred Degree: Associate .
Locations: .
City
State
Postal
Code
Country
Houston
TX;
77056
USA .
Contact Information: .
Contact Name: http://www.humana.com/careers .
Email: Click Here (apply to job) .
Job Code: 12361 .
This opportunity presented by IMDiversity, Inc.
Applicant Category: Professional
Requisition Code: Work at home
Two Initials of Recruiter: bw
System Date: 01/24/2007
System Time: 14:37:23
Document Name(40): Case Manager, RN - Houston
Source: IMDiversity.com - USA
SearchTerms: "work at home" "work from home"
URL(80): http://jobs.imdiversity.com/jobseekerx/ViewJob.asp?JobID=qEH7ukyJAwnAIhhMQdHN0X4
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