Nurse Case Manager jobs at UnitedHealth Group

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.** Registered Nurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities. The Field Case Manager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members. **Primary Responsibilities:** + Reports to RN Manager + Assess the health status of members as within the scope of licensure and with the frequency established in the model of care + Establish goals to meet identified health care needs + Plan, implement and evaluate responses to the plan of care + Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care + Works closely with mental health clinicians to help bridge the gap between mental and physical health + Consult with the patient's PCP, specialists, or other health care professionals as appropriate + Assess patient needs for community resources and make appropriate referrals for service + Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians + Completely and accurately document in patient's electronic medical record + Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit + Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations + Actively participate in organizational quality initiatives + Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery + Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs + Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Years of post-high school education can be substituted/is equivalent to years of experience. **Required Qualifications:** + Current unrestricted licensure as RN in Ohio + 2+ years of relevant experience + Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs + Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes) + Proven solid computer skills, including use of electronic medical records + Ability to travel 100% of the time for field-based work within 60 miles of residence + Valid driver's license + Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area **Preferred Qualification:** + Field based experience + Case management experience + Proven effective time management and communication skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP. Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members' evolving needs. Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence. Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone. Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs. Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery. Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness. Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan. Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes. Travel is necessary to conduct member visits and fulfill role responsibilities. Use your skills to make an impact Required Qualifications Four-year bachelor's degree in human services or related field with one (1) year of experience working with at least one of the Family Care target populations OR a four-year bachelor's degree in any other field with three (3) years' related experience working with at least one of the Family Care target populations. Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications. ***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities*** Preferred Qualifications Case Management experience Experience with electronic case note documentation and experience with documenting in multiple computer applications/systems Knowledge of community health and social service agencies and additional community resources Additional Information Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Work Location: Eau Claire and surrounding areas Travel: up to 40% throughout Eau Claire and surrounding areas. Mileage reimbursement follows our mileage policy. Typical Workdays/Hours: Monday - Friday, 8:00 am - 4:30 pm CST Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,700 - $72,600 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Location: Position is remote. Prefer candidate to live in PST time zone. Schedule: Looking for someone who will work Tuesday-Saturday. 8-5 PST. Position Purpose: Oversees correspondence letters based and supports overall team needs. Reviews outcomes in accordance with National Committee for Quality Assurance (NCQA) standards. Works with senior management to identify and implement opportunities for improvement. Oversees the clinical review of outcomes including creating and editing correspondence letters with the correspondence team based on determinations in accordance with National Committee for Quality Assurance (NCQA) standards Manages the audits of correspondence to ensure they are processed in accordance with Federal, State, and NCQA standards Provides expert insight and guidance on the clinical review process of correspondence to ensure compliance with all applicable State and Federal regulations Provides subject matter expertise insights to investigate and resolve issues including comprehensive review of clinical documentation, clinical criteria/guidelines, and policy, including insurance rejections due to coding issues and escalates as appropriate to resolve issues in a timely manner Acts as a point of contact for escalated, advanced issues and/or questions related to correspondence with the state, local, and federal agencies including third party payer and providers to ensure issues are resolved in a timely manner Oversees clinical quality and process improvement initiatives related to clinical quality indicators and financial metrics Manages data needed to identify trends and provide recommendations to senior management of process improvements within utilization management Manages and oversees cases to ensure timely resolution and logs of actions and/or decisions are appropriately documented Provides training and education to the interdepartmental teams on training needed within the utilization management team based on trends Partners with leadership to improve processes and procedures to prevent recurrences based on industry best practices Provides guidance, subject matter expertise and training as needed Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 5 - 7 years of related experience. Expert knowledge of Medicare and Medicaid regulations preferred. Expert knowledge of utilization management processes preferred. License/Certification: LPN - Licensed Practical Nurse - State Licensure required- Compact License Location: Position is remote. Prefer candidate to live in PST time zone. Schedule: Looking for someone who will work Tuesday-Saturday. 8-5 PST. Pay Range: $35.49 - $63.79 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. Job Description JOIN OUR GROWING TEAM Are you tired of bedside nursing? Are you looking to get away from 12-hour hospital shifts while continuing to utilize your RN expertise to impact the lives of patients in your local community? We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Registered Nurses to join our Workers' Compensation Field Case Management team. This opportunity offers a competitive salary, full benefits, and a performance-based bonus paid out on a monthly or quarterly basis. POSITION SUMMARY Responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel. Fundamental Components but not limited to the following: Assesses and analyzes an injured employees medical and vocational status; develops a plan of care to facilitate the patients appropriate and timely return to work. Interviews patients in their homes, work-sites, or physicians office to provide ongoing case management services. Monitors patient progress toward desired outcomes through assessment and evaluation. Communicates both in-person and telephonically with patient, medical providers, attorneys, employers and insurance carriers; prepares all required documentation of case work activities. May arrange referrals, consultations and therapeutic services for patients; confers with specialists concerning course of care and treatment. Develops and administers educational and prevention programs. Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. Testifies as required to substantiate any relevant case work or reports. Daily travel in the field. Qualifications BACKGROUND/EXPERIENCE: Registered Nurse (RN) with active state license in good standing in the state where job duties are performed required Minimum 2 years clinical nursing background required Bilingual Spanish Speaking Fluent preferred Prior case management and workers' compensation experience preferred Ability to multitask in a fast paced work environment Strong computer skills with experience in Microsoft Office Products Excellent communication skills EDUCATION The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience. LICENSES AND CERTIFICATIONS Nursing/Registered Nurse (RN) is required Nursing/Certified Case Manager (CCM) is desired Telework Specifications: Full time WAH with daily travel in the field. Candidates should reside in the San Fernando Valley/Los Angeles area. Additional Information We offer you: Autonomy Productivity incentive Home every night, weekend and holiday! Schedule Monday-Friday All major holidays are paid time off, vacation and sick time off is accrued. Full benefits offered including 401(k) and many corporate discounts available. Employees are reimbursed for fees to maintain licensure as well as free CEU's to maintain licensure . Continuing Education credits are available/provided for RN and a various industry certifications too . Work from home with in-state travel. In addition to annual salary, position has potential for a monthly monetary bonus. Mileage reimbursement is provided per the IRS rate. Coventry provides laptop, IPhone, fax/scanner/printer, as well as office supplies. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. All employees are expected to embody our values of Excellence, Integrity, Caring and Inspiration in all that they do as an employee. The overall responsibility of the Field Case Manager is to ensure the injured worker receives the best possible care in a timely and efficient manner towards full rehabilitation and return to work. Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Applicants for this role have the flexibility to work remotely from their home anywhere in the Central time zone. This role will support Iowa Medicaid members and requires an Iowa or compact nursing license. The work schedule is Monday - Friday, 8am - 5 pm, with rotating weekend / holiday coverage.** Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member. Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines Reviews member's transfer or discharge plans to ensure a timely discharge between levels of care and facilities Collaborates with care management on referral of members as appropriate Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related experience. 2+ years of acute care experience required. Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: LPN - Licensed Practical Nurse - State Licensure required Pay Range: $26.50 - $47.59 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. ****NOTE: This is a fully remote role with serving maternity and postnatal members with behavioral health conditions. Preference will be given to individuals who (1) possess an active Illinois registered nurse (RN) license, (2) have a combination of professional experience with high-risk maternity and behavioral health/substance use, as well as (3) virtual service coordination, case management, community advocacy. (4) Spanish language fluency is a plus. Additional Details: • Line of Business: Illinois Health Plan • Department: MED-Medical Management (Case Management) • Schedule: Monday through Friday, 8 AM to 5 PM Central • Caseload: behavioral health maternity members. **** Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs Identifies problems/barriers to care and provide appropriate care management interventions Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner Other duties or responsibilities as assigned by people leader to meet business needs Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 - 4 years of related experience. License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required For YouthCare Illinois plan only: Bachelor's Degree and IL RN licensure required. Must reside in IL For Sunshine Health (FL) Only: Employees supporting Florida's Children's Medical Services (CMS) must have a minimum of two years of pediatric experience. May require up to 80% local travel required Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Applicants for this position must reside in the state of Kansas or the Kansas City metro area as the role requires up to 10% local travel. A Kansas or compact RN license is required. The work schedule is Monday - Friday, 8am - 5pm.** Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs Identifies problems/barriers to care and provide appropriate care management interventions Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner Other duties or responsibilities as assigned by people leader to meet business needs Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 - 4 years of related experience. License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. Registered Nurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities. The Field Case Manager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members. Primary Responsibilities: * Reports to RN Manager * Assess the health status of members as within the scope of licensure and with the frequency established in the model of care * Establish goals to meet identified health care needs * Plan, implement and evaluate responses to the plan of care * Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care * Works closely with mental health clinicians to help bridge the gap between mental and physical health * Consult with the patient's PCP, specialists, or other health care professionals as appropriate * Assess patient needs for community resources and make appropriate referrals for service * Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians * Completely and accurately document in patient's electronic medical record * Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit * Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations * Actively participate in organizational quality initiatives * Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery * Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs * Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Years of post-high school education can be substituted/is equivalent to years of experience. Required Qualifications: * Current unrestricted licensure as RN in Ohio * 2+ years of relevant experience * Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs * Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes) * Proven solid computer skills, including use of electronic medical records * Ability to travel 100% of the time for field-based work within 60 miles of residence * Valid driver's license * Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area Preferred Qualification: * Field based experience * Case management experience * Proven effective time management and communication skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. LTSS RN Case Manager - provide case management to ADULT members LOCATION: Austin, TX and surrounding Central Texas area Hybrid position - 3 days per week for member visits and work from home Monday - Friday: 8 am - 5 pm (CST) Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care plan / service plan for long-term care members, addresses issues, and educates members and their families/caregivers on services and benefit options available to receive appropriate high-quality care. Evaluates the service needs of the most complex or high risk/high acuity members and recommends a plan for the best outcome Develops and continuously assesses ongoing long-term care plans / service plans and collaborates with care management team to identify providers, specialists, and/or community resources needed to address member's needs Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / needs Monitors member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations Reviews referrals information and intake assessments to develop appropriate care plans / service plans Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines Provides and/or facilitates education to long-term care members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits Acts as liaison and member advocate between the member/family, physician, and facilities/agencies Educates on and coordinates community resources. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living) May perform home and/or other site visits (e.g., once a month or more), such as to assess member needs and collaborate with resources, as required Partners with leadership team to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice May engage and assist New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4-6 years of related experience Bachelor's degree in Nursing preferred License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required or NP - Nurse Practitioner - Current State's Nurse Licensure required Resource Utilization Group (RUG) certification must be obtained within 90 days of hire required Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Become a part of our caring community and help us put health first Humana Healthy Horizons in Virginia is looking for RN, Field Care Managers (Field Care Manager Nurse 2) who performs primarily face to face and telephonic assessments to adult and pediatric members. The RN, Field Care Manager (Field Care Manager Nurse 2) will evaluate member's needs to achieve and/or maintain optimal wellness. This position employs a variety of strategies, approaches, and techniques to manage a member's health issues and identifies and resolves barriers that hinder effective care. They ensure members are progressing towards desired outcomes by continuously monitoring care through use of assessment, data, conversations with member, and active care planning. The RN, Field Care Manager (Field Care Manager, Nurse 2) understands professional concepts, regulations, strategies, and operating standards. They make decisions regarding work approach/priorities and follows direction. Responsible for managing a case load and completing assessments with members in their home or community-based setting, as well as telephonically. Provides clinical support and guidance, particularly for members with medical complexity. Develops and coordinates care plans ensuring that patients receive appropriate services to manage their health needs effectively. Addresses barriers to health care and advocating for optimal member outcomes. Reviews, assesses, and completes medical complexity attestations and clinical oversights. Ensures members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs. Develops and modifies Individual Care Plan and involve applicable members of the care team in care planning (Informal caregiver, coach, PCP, etc.). Focuses on supporting members and/or caregivers utilizing an interdisciplinary approach in accessing social, housing, educational and other services, regardless of funding sources to meet their needs. Collaborates with Community Health Workers (CHW), Housing Specialist and other internal and external agencies for HRSN needs. Primary point of contact for the ICT and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member's needs are met. Use your skills to make an impact Required Qualifications Must reside in the Commonwealth of Northern Virginia Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action. Two (2) years of prior experience in health care and/or case management. One (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria (adults, pediatrics populations at risk for chronic medical conditions and high social needs). Strong advocate and respect for members at all levels of care. Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook. Ability to use a variety of electronic information applications/software programs including electronic medical records. Exceptional oral and written communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders. Ability to work with minimal supervision within the role and scope. Ability to work a full-time schedule. Preferred Qualifications Prior experience with Medicare, Medicaid and dual eligible populations. Bachelor's Degree Nursing (BSN). Case Management Certification (CCM). Experience with health promotion, coaching and wellness. Knowledge of community health and social service agencies and additional community resources. Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. See “Additional Information” section for more information. Additional Information Workstyle: Field - This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Travel: 50 - 75% field interactions with members, and their families and providers. May need to attend onsite meetings occasionally in Humana Healthy Horizons office in Glen Allen, VA. Workdays and Hours: Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST). Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Alert Statement Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. TB Screening This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Driving Statement This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance-no nights or weekends, giving you more time for what matters most. Humana is currently seeking RN Case Managers to join our teams in the La Crosse and Sparta offices, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana.Key responsiblities: Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan. Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care plans that support their continued health and safety. Contribute to the creation, continuous evaluation, and coordination of the member's plan of care, including coordinating with outside providers to provide support with medication administration, assistance with home care, skilled nursing visits, and related services to ensure comprehensive care. Contact and coordinate with acute and primary care providers. Promote health and wellness through patient education on disease prevention, nutrition, exercise and lifestyle modifications. Provide members with education and information about disease processes and related risks, supporting informed decision-making while respecting each individual's autonomy. Daily documentation in member files within required DHS contract timeframes. Participate in member monthly phone contacts and attend in person visits in members setting. Traveling will be required and eligible for mileage reimbursement. Use your skills to make an impact Required Qualifications Associate degree in nursing. Must be a Registered Nurse, licensed in the state of Wisconsin in good standing. Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications. Preferred Qualifications Bachelor degree in nursing. One (1)+ years of experience with Family Care target group: frail elders and adults with intellectual, developmental, or physical disabilities. Care Management experience Additional Information Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Work Location: Either La Crosse WI or Sparta WI and surrounding area. Travel: up to 40% throughout assigned area and surrounding areas Typical Work Days/Hours: Monday through Friday, 8:00 am - 4:30 pm CST. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driving This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. TB This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Modern Hire As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. SSN Alert Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's 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. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are-whether you are working from home, from the field, from our offices, or from somewhere in between-you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone's voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! Position Responsibilities: The Care Coordinator 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. Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care. Responsible for the coordination of all the member's needed medical and non-medical services, including functional, social, and environmental services. Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member's identified needs Coordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare. Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member's needs are met. Use your skills to make an impact Required Qualifications Licensed Registered Nurse (RN) in the state of Indiana without restrictions At least one (2) years of clinical experience as a nurse in providing case management or similar health care services (internal note: could be LPN experience if relevant) Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook. Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders. Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills. Ability to manage multiple or competing priorities in a fast-paced environment. Ability to use a variety of electronic information applications/software programs including electronic medical records. Live/Reside in Indiana Preferred Qualifications Bilingual (English/Spanish) or (English/Burmese) Prior nursing home diversion, long-term care, disease management, or case management experience Prior management of Home and Community Based Services waivers (HCBS dual roles only) Prior experience with Medicare & Medicaid recipients Experience working with a geriatric population Experience with health promotion, coaching and wellness Knowledge of community health and social service agencies and additional community resources Additional Information About Humana Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without you This is a place where our nurses influence the C-suite. Where software engineers change lives. Where every associate can build a professional path where they learn and thrive. Through our commitments to wellbeing and work-life balance, we support each associate's personal health, purpose, work style, sense of belonging, and security. Because finding new ways to put health first-for our members and patients and our associates alike-is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with members. On Call-Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's license Proof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limits Access to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. The Care Manager Telephonic Nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. 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 The Care Manager Telephonic Nurse employs a variety of strategies, approaches and techniques to assess, intervene, and resolve Access to Care (ATC) barriers related to immediate medical services. The nurse will facilitate verified eligible Humana benefits to a provider and/or member while effectively documenting through assessments and/or evaluations while maintaining compliance with CMS regulations. The Care Manager Telephonic Nurse must also assess for member physical, environmental, and psycho-social health issues and intervene appropriately. Use your skills to make an impact Required Qualifications Minimum of an Associate's degree in Nursing Licensed Registered Nurse (RN) with no disciplinary action Must have a valid Compact RN license in the state where they reside. Candidates must reside in a Compact state (excluding CA, IL, MI, NY, OR, AK, DC (District of Columbia), HI, NV, MA, MN, and PR). 3 years or more of clinical acute care experience Comprehensive knowledge of all Microsoft programs including but not limited to Word, Outlook, PowerPoint, SharePoint, OneNote and Excel Preferred Qualifications Bachelor's degree - BSN Experience with case management, discharge planning, and patient education for adult acute care Managed care experience Previous Medicare/Medicaid experience Bilingual English/Spanish Additional Information Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. Work At Home / Internet Statement: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Alert Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.Application Deadline: 01-04-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first We are seeking a dedicated and compassionate Registered Nurse with a Bachelor of Science in Nursing (BSN) to join our team as a Care Manager, Telephonic Nurse 2. In this pivotal role, you will play a crucial part in our Patient Management Program, focusing on individuals with specialized and complex health conditions, including autoimmune disorders, pulmonary diseases, neuromuscular disorders, infectious diseases, cancer(s), and other rare ailments. As a Care Manager, Telephonic Nurse your primary responsibility will be to assess and evaluate the conditions of our members, with a particular emphasis on medication therapy, through telephonic interactions to ensure they achieve and maintain optimal wellness. Additionally, you will develop and implement comprehensive care plans, monitor patient progress through regular assessments, and utilize advanced telecommunication systems to provide medication education. The ideal candidate will demonstrate strong clinical expertise, exceptional communication skills, and the ability to work independently while adhering to established protocols and guidelines. This position offers the opportunity to make a significant impact on the lives of patients with serious and rare health conditions within a supportive and professional environment. Use your skills to make an impact This position is a call center based environment. There is a set schedule that is provided daily with inbound and outbound tasks to perform. This position is for 10am-6:30pm EST three days a week M-F, and two days a week hours of 11:30am-8pm EST. There will be a Friday late night requirement on a rotation of 11:30am-8pm. There will be a Saturday rotation hours of 8:30am-12:30pm EST. Overtime is required on an as needed basis. There is a Holiday rotation that will be worked. Workable holidays for the pharmacy include Martin Luther King Day, Memorial Day, Juneteenth, 4th of July, Labor Day, The day after Thanksgiving, and New Years Day. Required Qualifications Must have Completed Bachelor's Degree in Nursing 3 - 5 years of clinical acute care experience Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action Must live in OH, KY, FL, AZ, TX. Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Preferred Qualifications Experience with care management, patient education for adult care, auto dialer experience Bilingual English/Spanish Auto Dialer Experience Additional Information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. About us About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

**Become a part of our caring community and help us put health first** The Compact licensed telephonic Care Manager works from home in a call center environment. They assess and evaluate members' needs and requirements to achieve or maintain optimal wellness by providing care coordination and facilitating member or family interaction with resources appropriate for the care and wellbeing of the member. **Job Description** Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management services are centered on the person rather than the condition. The Care Manager uses a range of strategies and techniques to manage a member's physical, environmental, and psycho-social health issues. They identify and resolve barriers to effective care and continuously monitor progress through assessments and evaluations to ensure members achieve their desired health outcomes. **Role Overview** + The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. + This role operates in a fast-paced environment, requiring the ability to quickly engage with members while navigating multiple computer applications simultaneously. To maintain compliance and support the auto-dialer process critical to our operations, care managers follow structured daily schedules, which limits day-to-day flexibility **.** + All our RN Care Managers are work at home associates, working from a dedicated home office space (see Work at Home Guidance below). + Remote Care Managers are expected to achieve established outcomes, quality, and productivity benchmarks and demonstrate advanced communication and interpersonal skills. **Duties Include** + Telephonically working with Medicare members with transitional needs and complex chronic conditions. + Assessing members' physical, environmental, and psychosocial health needs, collaborating with a multidisciplinary team, and implementing timely clinical interventions to manage risks, coordinate care, and help prevent avoidable hospitalizations. + Collaboration with members who face multiple chronic conditions, along with financial and functional challenges, to support them in achieving and sustaining optimal health. + May develop individualized member care plans. Success in this position requires that you + Understand department, segment, and organizational strategies and objectives, and how they connect to related areas. + Exercise judgement regarding own work methods, even in ambiguous situations, with minimal direction and occasional guidance where needed. + Demonstrate flexibility and ability to promptly adapt to new processes and workflows. + Adhere to established guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse (R.N.) license with **no** disciplinary action on any license. + **Must hold an active Compact nursing license and reside in the state that holds your compact license.** + 3+ years of clinical acute care experience with case management, discharge planning, and patient education for adult acute care + Demonstrated clinical expertise in managing chronic conditions through individualized care planning, supported by strong assessment and critical thinking skills + Proficiency in Microsoft Office applications including Word, Excel, and Outlook. + Demonstrated proficiency in navigating multiple systems using dual monitors, with strong computer skills and the ability to quickly learn new applications. Skilled in autonomous decision-making, troubleshooting, and problem-solving system-related issues **Preferred Qualifications** + BSN or MSN degree + Case Management experience + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see Language Proficiency Testing below) **Training and Work Schedule** + The first 4 weeks of training work hours will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training. + Following training, work hours are: + **If you live in the Eastern Time Zone (EST):** Work hours are 9:00 AM to 5:30 PM EST. + **If you live in the Central Time Zone (CST):** work hours are 10:00 AM to 6:30 PM EST **Work at Home Guidance** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is also required. Satellite, cellular and microwave connection is not allowed. + On occasion, the personal level of internet service a Home or Hybrid Home/Office associate provides-despite meeting the minimum requirement above-proves to be insufficient to maintain an optimal connection through Humana's VPN and thereby interferes with the Home or Hybrid Home/Office associate's ability to work effectively. When this happens, Humana reserves the right to require the associate to upgrade the level of his/her personal internet service as a condition of employment. Based on system requirements, you may need a download speed of up to 200 Mbps and an upload speed of 20 Mbps. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Language Proficiency Testing** Any Humana associate who wishes to communicate with members in a language other than English must complete a language proficiency assessment, administered by an approved external vendor, to ensure fluency and competency in that language Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. **Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Please note during the screening process, you will be asked to provide your Compact Nursing license number and your internet upload and download speeds from** ********************* . **These items will be required prior to scheduling an interview.** **Social Security Task** Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Become a part of our caring community and help us put health first Work Schedule: Full-time/40 Hours On-site This is NOT a remote or work-from-home position. This position requires you to sit on-site at our Marion, OH branch location. The RN Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. This role is a focused on both home health clinical quality assurance and home health clinical operations initiatives. * Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. * Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. * Manages the assignment of caregivers. * Responsible for and oversees the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make the decision to admit patients to service. Assigns appropriate clinicians to a case, as needed. * Instructs and guides clinicians to promote more effective performance and delivery of quality home care services, and is available at all times during operating hours to assist clinicians as appropriate. * Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC). * Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. * Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning. * Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. * Participates in sales and marketing initiatives. * Supervises all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in accordance with Company policies and procedures. * Handles necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations. * Participates in the interviewing, hiring, training, and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in-service education programs, when needed. Ensures adherence to internal policies and standards. * Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed. * Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through the utilization of Performance Improvement principles. * Responsible for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, for appropriateness of care, delivery, and documentation requirements. * Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. Competently performs patient care assignments and staff management activities. * Provides direct patient care on an infrequent basis and only in times of emergency. * Acts as Branch Director in his/her absence. * Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical documentation meets internal standards. * Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. * Maintains relationships with referral/community sources. Participates in professional organizations and conducts care-related programs. * Performs other related duties as assigned or requested. Use your skills to make an impact Required Experience/Skills: * Graduate of an accredited School of Nursing. * Current state license as a Registered Nurse. * Proof of current CPR. * Valid driver's license, auto insurance and reliable transportation. * Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment. * Home health experience is required. * Management and people leadership experience, preferred. * OASIS experience, required. OASIS certification (HCS-O, COQS, and/or COS-C), preferred. * Homecare Homebase (HCHB) experience, required. * CMS PDGM billing knowledge and/or experience, preferred. Additional Information * Normal Hours of Operation: M-F / 8a-5p (ET) * On-Call Expectation: Rotating on-call shift. * Branch Size: 105 Census (3.5 STAR rating) Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,200 - $106,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

**Become a part of our caring community and help us put health first** The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. The Care Manager Telephonic Nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. 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 The Care Manager Telephonic Nurse employs a variety of strategies, approaches and techniques to assess, intervene, and resolve Access to Care (ATC) barriers related to immediate medical services. The nurse will facilitate verified eligible Humana benefits to a provider and/or member while effectively documenting through assessments and/or evaluations while maintaining compliance with CMS regulations. The Care Manager Telephonic Nurse must also assess for member physical, environmental, and psycho-social health issues and intervene appropriately. **Use your skills to make an impact** **Required Qualifications** + Minimum of an Associate's degree in Nursing + Licensed Registered Nurse (RN) with no disciplinary action + Must have a valid Compact RN license in the state where they reside. **Candidates must reside in a Compact state (excluding CA, IL, MI, NY, OR, AK, DC (District of Columbia), HI, NV, MA, MN, and PR).** + 3 years or more of clinical acute care experience + Comprehensive knowledge of all Microsoft programs including but not limited to Word, Outlook, PowerPoint, SharePoint, OneNote and Excel **Preferred Qualifications** + Bachelor's degree - BSN + Experience with case management, discharge planning, and patient education for adult acute care + Managed care experience + Previous Medicare/Medicaid experience + Bilingual English/Spanish **Additional Information** + Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. + Work schedule can be between 8am-6:30pm EST. **Work At Home / Internet Statement:** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **SSN Alert Statement:** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. Application Deadline: 01-04-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Registered Nurse Case Manager, you will assume full nursing responsibility for the delivery of the Plan of Care for each hospice patient. Continuously evaluating personal and professional performance and making necessary changes to increase productivity and quality of care delivered. You'll also develop the patient's Plan of care in collaboration with other professionals and implement treatment strategies based on scientific nursing theory that promotes physical, psychosocial, emotional, and spiritual well-being. Familiar with the concepts and needs of patients/families who are facing death and dying. Primary Responsibilities: * Makes the initial nursing evaluation in determining eligibility for hospice services during visit within forty-eight (48) hours of referral * Identifies the patient's/family's physical, psychosocial, and environmental needs and re-assesses as needed, no less than every fifteen (15) days * Initiates and coordinates the plan of care * Documents problems, appropriate goals, interventions, and patient/family response to hospice care * Collaborates with the patient/family, attending physician and other members of the IDG in providing patient and family care daily * Instructs and supervises the patient/family in self-care techniques when appropriate * Maintains accurate and relevant clinical notes regarding the patient's condition You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current and unrestricted RN licensure in the state of practice * 1+ years of clinical experience * Current CPR Certification * Current driver's license, valid vehicle insurance, and access to a dependable vehicle, or public transportation * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: * Able to work independently * Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Explore opportunities with Caretenders Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Registered Nurse Case Manager, you will assume full nursing responsibility for the delivery of the Plan of Care for each hospice patient. Continuously evaluating personal and professional performance and making necessary changes to increase productivity and quality of care delivered. You'll also develop the patient's Plan of care in collaboration with other professionals and implement treatment strategies based on scientific nursing theory that promotes physical, psychosocial, emotional, and spiritual well-being. Familiar with the concepts and needs of patients/families who are facing death and dying. Primary Responsibilities: * Makes the initial nursing evaluation in determining eligibility for hospice services during visit within forty-eight (48) hours of referral * Identifies the patient's/family's physical, psychosocial, and environmental needs and re-assesses as needed, no less than every fifteen (15) days * Initiates and coordinates the plan of care * Documents problems, appropriate goals, interventions, and patient/family response to hospice care * Collaborates with the patient/family, attending physician and other members of the IDG in providing patient and family care daily * Instructs and supervises the patient/family in self-care techniques when appropriate * Maintains accurate and relevant clinical notes regarding the patient's condition You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current and unrestricted RN licensure in the state of practice * 1+ years of clinical experience * Current CPR Certification * Current driver's license, valid vehicle insurance, and access to a dependable vehicle, or public transportation * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: * Able to work independently * Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. #LHCjobs UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.