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Title: Humana Cares Manager - Bilingual Spanish/EnglishLocation: US-FL-Saint PetersburgRole:Humana Cares ManagerAssignment: Humana Cares-CarePlus Special Needs PlanLocation: Saint Petersburg, FLAre you a fit?Are you a caring, committed nurse who is fascinated with health and fascinated with how people relate their personal actions to their health? Are you a self-starter? If you answered yes, continue reading to learn more and decide if this role is for you!Assignment CapsuleThe Humana Cares Manager will telephonically assess CarePlus Special Needs Plan members in 7 domains of functioning; Evaluate member needs and requirements to achieve and/or maintain optimal wellness state. Will guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. Work in collaboration with a multi-disciplinary team, employing a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.Other responsibilities include:* Proactive telephonic outreach to eligible Humana members and engage participation in Humana Cares Complex Care Management program. * Actively participate in all enrollment activities. * Complete physical, psychological, emotional and environmental assessments, for the purpose of providing appropriate, timely interventions to ensure provision of optimal care. * Coordinate community care and services as deemed appropriate. * Works Collaboratively with other members of the Humana Cares Interdisciplinary team-to include; Humana Cares Managers-Social Services, Field Care Managers and Community Health Educators. * Understand clinical program design, implementation, and management, monitoring and reporting. * Comply with performance and reporting standards as defined by Humana Corporation. * Additional responsibilities as deemed appropriate by Humana Cares leadership.Key Competencies* Builds Trust: Walks the talk; makes choices that are consistent with Humana's ethical principles; is emotionally intelligent; manages self and relationships effectively, through self-awareness, self-management, awareness of others and skill in dealing with others. * Implementation / Execution: Effectively leverages available resources (financial, people, time) to accomplish objectives and maximize return on investment. Makes appropriate decisions in the face of ambiguity. Anticipates and resolves barriers and constraints. Organizes and manages multiple priorities and/or projects using appropriate methodologies and tools. * Innovates: Introduces or develops new ideas and processes which improve performance and productivity. Generates insights through thought leadership. Leverages business intelligence, data, insights, and other research to drive differential value and expand Humana's capability to compete. * Problem Solving: Proactively identifies, evaluates, and solves problems with rigorous logic and a systematic approach; looks beyond the obvious to see root cause issues and creative solutions.Role Essentials* Active Registered Nurse (R.N.) license and possess the ability to be licensed as a registered nurse in multiple states without restrictions. * Seasoned professional nurse with 3 years of clinical nursing experience. * Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in English/Spanish. * Exceptional communication and interpersonal skills. * Ability to interact effectively with multi-disciplinary team members. * Intermediate to Advanced Computer skills and knowledge of Microsoft Word and Excel. * Excellent keyboard and web navigation skills. * Ability to use a variety of electronic information applications/software programs. * Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work. * Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role). * Ability to travel, work and train onsite plus additional travel as needed for ongoing training. * Ability to work a full-time (40 hours minimum) flexible work schedule.Role Desirables* Bachelor's degree in Nursing (B.S.N.) * Previous telephonic case management experience working in the medical/insurance field. * Previous managed care experience. * Experience with behavior change, health promotion, coaching and wellness. * Recent clinicalnursing experience in critical care or medical-surgical settings.Reporting Relationships* You will be in the Humana Cares area under the direction of a Humana Cares Coach - Care PlusAdditional Information* This position offers work at home potential (per discretion of Humana Cares leadership) after successful completion of a 6 month evaluation process.Role: Clinical Innovations and Health Practitioners
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