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Case Manager, RN - Phoenix
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Case Manager, RN - Phoenix; | Humana ; | Phoenix AZ 85016 USA; | Full Time .
Requirements; | Details; | Locations; | Contact .
Job Description: .
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies, with approximately 13 million medical members located primarily in 15 states and Puerto Rico. 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, 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.
Case Manager, RN, PhoenixMinimum 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. This position is a work at home position, and will perform onsite CM duties with daily travel to one or more facilities in Phoenix, AZ. 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. .