Telephonic Behavioral Health Care Manager RN- Bilingual Spanish preferred- WAH Nationwide

DescriptionThe Behavioral Health Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.ResponsibilitiesHumana is seeking a Behavioral Health Care Manager to telephonically assess, evaluate, and support members who are challenged by both serious mental illness and complex medical situations. Our goal is to provide support for both mind and body to allow each member to achieve and/or maintain their optimal health.The Behavioral Health Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. Will create member care plans/identify gaps in care and work towards closing gaps in care. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.This position requires flexibility to work an 8 hour shift between 8AM and 8PM Eastern Time with occasional overtime offered.Required QualificationsMinimum 2 years in an integrated care setting managing members with both Medical and Behavioral Health needs and/or Substance Use

Licensed RN in the state where you reside with the ability to obtain additional state licensure as needed

Intermediate comprehension of Microsoft Office applications including Word and Outlook

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

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 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); and recommended speed for optimal performance from Humana systems is 25M x 10M

Preferred QualificationsBachelor's degree

Fluency in both Spanish and English

Experience working with disabled population

Experience with case management, discharge planning and patient education for adult acute care

Knowledge of Milliman or Interqual

Managed care experience

Certified Case Manager (CCM)

Additional InformationSchedule: Monday-Friday, 8AM-8PM EST (8 hour shifts)Scheduled Weekly Hours40