Onsite Nurse - RN occupation at Humana in Overland Park

Humana is at the momment seeking for Onsite Nurse - RN on Tue, 12 Nov 2013 23:14:24 GMT. Be a part of our Clinical Space â€" as a Clinical Advisor you will engage our members to develop lifelong wellbeing and health. Humana is seeking a Clinical Medicare Case Manager Nurse who will work with identified members to assess their care needs, assist in planning and implementing interventions to meet those needs, assist in coordinating services, and monitor and evaluate the case management...

Onsite Nurse - RN

Location: Overland Park Kansas

Description: Humana is at the momment seeking for Onsite Nurse - RN right now, this occupation will be placed in Kansas. More details about this occupation opportunity kindly see the descriptions. Be a part of our Clinical Space â€" as a Clinical Advisor you will engage our members to develop lifelong wellbeing and health.

Humana is seeking a Clinical Medicare Case Manager Nurse who will work with ide! ntified members to assess their care needs, assist in planning and implementing interventions to meet those needs, assist in coordinating services, and monitor and evaluate the case management plan against the member’s personal health care goals. You will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines review criteria.

Manage network participation, care with specialty networks, care with DME providers and transfers to alternative levels of care using your knowledge of benefit plan design

Recommend services for Humana Plan members using care alternatives available within the community and nationally

Examine clinical programs information to: manage our members on an outpatient basis and develop strategies to prevent readmission; mine health risk assessment data reports to identify potentially high-risk membership; identify and refer members to D! isease Management Programs; conduct discharge planning; coordi! nate Behavioral Health management

Coordinate: in versus out-of-network movement; care in out-of-network facilities; care with specialty networks; care with DME providers; transfers to SNF and back

Conduct post-discharge calls and discharge planning

Key Competencies

Builds Trust

: Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions.

Accountability

: Meets established expectations and takes responsibility for achieving results; encourages others to do the same.

Customer Focus

: Connects meaningfully with customers to build emotional engagement and customer advocacy. Simplifies complexity and integrates internal efforts to deliver an optimal customer experience.

Executes for Results

: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively re! solves barriers and constraints.

Qualifications

Role Essentials

Current RN license in the state in which the nurse will be required to practice

Ability to be licensed in multiple states without restrictions

2-5 clinical experience preferably in an acute care, skilled or rehabilitation clinical setting

Ability to work independently under general instructions and with a team

Valid drivers license and/or dependable transportation necessary (variable)

Role Desirables

Education: Associate or Bachelor's degree in Nursing

Special Certifications: Case Management Certification

Health Plan experience • Previous Case Management experience

Medicaid/Medicare experience

Call center or triage experience

Bilingual is a plus

Additional Information

At Humana, we know your well-being is important to you, and it’s important to us too.! That’s why we’re committed to making resources available to you th! at will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.

After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on what’s happening around our organization in the changing world of healthcare.

Schedule

:

Full-time

Primary Location

:

US-Kansas-Overland Park

Role

:

Clinical Innovations and Health Practitioners

Work Environment Type

:

Office

Travel

:

Yes, 20 % of the Time
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Humana.

If you interested on this occupation just click on the Apply button, you will be redirected to the official website

This occupation starts available on: Tue, 12 Nov 2013 23:14:24 GMT

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