Humana · 5 months ago
RN Care Manager - Remote, nationwide
Humana Inc. is committed to putting health first and is seeking a RN Care Manager to join their team. This role involves telephonically assessing members' health issues and creating actionable care plans while collaborating with a multidisciplinary team to support members in achieving optimal health outcomes.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Telephonically assess Medicare, Medicaid, and/or and Group Account members and create actionable and measurable care plans to help guide and track the members' progress toward goals
Use nursing judgment to assess and coordinate care for acute situations (APS, EMS)
Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc
Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
Assess member’s physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention
Qualification
Required
Active Registered Nurse (R.N.) license with no disciplinary action
Hold an active Compact nursing license and reside in the state that holds your compact license
Minimum education of an Associates degree in Nursing
Seasoned RN with a minimum of 3 years of clinical nursing experience
Demonstrated clinical knowledge and expertise as evidenced by providing intervention to manage variety chronic conditions, including development and implementation of individualized care planning
Intermediate to advanced computer skills as evidenced by ability to navigate multiple systems, utilizing dual computer monitors
Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues
Experience with Microsoft and Excel
Ability to quickly learn and navigate software programs and applications
Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously
Effective communication and interpersonal skills
Effective problem solving and appropriate application of clinical knowledge
Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work
Must possess advanced telephonic and virtual communication skills
Preferred
BSN or MSN degree in nursing or equivalent
Previous adult chronic conditions care management
Previous experience in care management including knowledge of complex care management and care management principles
Experience with motivational interviewing
Experience with MCG or CMS guidelines, assessment and documentation practice
Case Management certification (CCM)
Bilingual in English and Spanish
Benefits
Benefits starting day 1 of employment
Competitive 401k match
Generous Paid Time Off accrual
Tuition Reimbursement
Parent Leave
Go365 perks for well-being
Medical, dental and vision benefits
401(k) retirement savings plan
Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
Short-term and long-term disability
Life insurance
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Recent News
2026-01-16
2026-01-16
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