Bilingual RN Care Manager - Remote, nationwide

Become a part of our caring community

The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.

The first 4 weeks of training will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training. Following training, the start time is 10:00AM -6:30PM EST. Must be bilingual in Spanish and English.

Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We contact members with multiple chronic conditions as well as financial and functional barriers in order to assist them in achieving and maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence, while using a multidisciplinary team.

This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care Managers are work at home associates, working from a dedicated home office space. Work at home care managers are responsible for meeting quality and productivity measures daily and maintaining working home internet at all times with demonstrated advanced communication and interpersonal skills.

This is a very compliance driven and highly visible program at Humana. The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. Environment is fast paced and requires ability to engage quickly with member while concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility in care manager's schedule.

Duties

• Telephonically assess Medicare, Medicaid, and/or and Group Account members and create actionable and measurable care plans to help guide and track the members' progress toward goals
• Use nursing judgment to assess and coordinate care for acute situations (APS, EMS)
• Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc.
• Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
• Assess member's physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention

Use your skills to make an impact

Required Qualifications

• Active Registered Nurse (R.N.) license with no disciplinary action.
• Hold an active Compact nursing license and reside in the state that holds your compact license.
• Must be bilingual in Spanish and English - resume must be submitted in English
• Oral and written fluency in Spanish and English - ability to pass a language test will be required.
• Minimum education of an Associates degree in Nursing.
• Minimum of 3 years of clinical RN experience.
• Experience using clinical knowledge to manage various adult chronic conditions, including development and implementation of individualized care planning.
• Proficient computer skills with ability to quickly learn and navigate multiple systems, utilizing dual computer monitors.
• Experience with Microsoft and Excel
• Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues.
• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
• Effective telephonic and virtual communication skills.
• Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.

Preferred Qualifications

• BSN or MSN degree in nursing or equivalent
• Previous adult chronic conditions care management
• Previous experience in care management including knowledge of complex care management and care management principles
• Experience with motivational interviewing
• Experience with MCG or CMS guidelines, assessment and documentation practice
• Case Management certification (CCM)

Work at Home Requirements

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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Additional Information

• Scheduled Weekly Hours: 40
• Pay Range: $71,100 - $97,800 per year (plus bonus incentive plan)
• Application Deadline: 07-23-2026

About Humana

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare 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.

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.