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Description
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.
Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.
Case Manager, RN - Medicare
Baton Rouge or Metairie, LA
Full time - Regular
Minimum Requirements:
Registered Nurse
Currently holds a valid license without restrictions in their designated location; ability to receive multi-state licensure as needed.
Associate Degree in Nursing, Management or Health Related Field.
At least 5 years of clinical experience in an acute clinical medical setting.
Previous experience in case management, utilization management or discharge planning.
CCM (Certified Case Manager) certification or eligibility desired.
Bilingual desired.
The Case Manager supports Humana members by identifying and utilizing appropriate healthcare resources most consistent with the member(s) needs and by providing guidance along the healthcare continuum.
The clinical advisor works with identified health plan members to assess their care needs, assist in coordinating interventions and services to meet those needs, and communicating with members, providers and Humana associates to promote efficient use of the healthcare system.
The clinical advisor utilizes knowledge of benefit plan design and care alternatives available within the community and nationally in order to recommend services that represent the delivery of appropriate health care services for Humana Plan members as ordered by the member's care provider(s).
This position will be located at theBaton Rouge or Metairie, LA, office.
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