Moms First Maternity, Telephonic Nurse at Humana

About the position At Humana, we prioritize health and well-being, not just for our members but also for our employees. As a part of Humana Healthy Horizons, you will be joining a team that is dedicated to helping individuals achieve their best health through a community-focused approach. This role is primarily telephonic, allowing you to assess and evaluate the needs of enrollees, particularly those with maternal health needs, and guide them towards appropriate resources for their care and well-being. You will collaborate with an interdisciplinary care management team, which includes community health workers and care management support assistants, to ensure that enrollees receive holistic, person-centered care. Your clinical expertise will be crucial in determining when face-to-face support is necessary, and you will coordinate in-person meetings as needed. This position requires independent decision-making and the ability to navigate ambiguous situations while following established guidelines and procedures. You will be responsible for creating care plans, monitoring progress, and resolving barriers to effective care, all while ensuring that enrollees are on track to achieve their desired health outcomes. Responsibilities • Perform telephonic and face-to-face assessments and evaluations of the member's needs and requirements to achieve and/or maintain an optimal wellness state. , • Guide members/families toward the appropriate resources for care and overall well-being. , • Ensure members are progressing towards desired outcomes by continuously monitoring care through assessments and evaluations. , • Create member care plans based on individual needs. , • Employ a variety of strategies, approaches, and techniques to manage an Enrollee's behavioral, physical, environmental, and psycho-social health needs. , • Identify and resolve barriers that hinder effective care. , • Make decisions about work methods with minimal direction, receiving guidance as needed. , • Collaborate with providers and community services to promote quality and cost-effective outcomes. , • Travel periodically to the Humana Oklahoma City office for meetings and training. Requirements • Must reside in Oklahoma. , • Active Registered Nurse (RN) license in Oklahoma (without restrictions). , • 2 or more years of experience in in-home case or care management. , • Minimum 1-year acute care experience working in obstetrics, women's care, labor and delivery, mother-baby, NICU, and/or clinical triage. , • Experience working with Medicaid and/or Medicare Enrollees to coordinate services, care needs, or benefits. , • Knowledge of community health and social service agencies and additional community resources. , • Exceptional communication and interpersonal skills with the ability to quickly build rapport. , • Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint. , • Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. Nice-to-haves • Case Management Certification (CCM). , • Bilingual Spanish preferred. Benefits • Health benefits effective day 1. , • Paid time off, holidays, volunteer time, and jury duty pay. , • Recognition pay. , • 401(k) retirement savings plan with employer match. , • Tuition assistance and scholarships for eligible dependents. , • Parental and caregiver leave. , • Employee charity matching program. , • Career development opportunities. Apply Job!