Remote Director, Care Management (RN) – Puerto Rico

Job Overview

  • Clinical License LPN
  • State(s) PR

About this job

Become a part of our caring community and help us put health first

The Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Director, Care Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

 

The Director, Care Management oversees the assessment and evaluation of members’ 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. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational

Become a part of our caring community and help us put health first

The Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Director, Care Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

 

The Director, Care Management oversees the assessment and evaluation of members’ 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. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.

Use your skills to make an impact

Required Qualifications

  • Our Department of Defense contract requires U.S. Citizenship
  • Successfully receive interim approval for government security clearance (eQIP – Electronic Questionnaire for Investigation Processing)
  • HGB is not authorized to do work in Puerto Rico per our government contract.  We are not able to hire candidates that are currently living in Puerto Rico.
  • Bachelor’s degree
  • Active unrestricted RN license
  • 5 years of clinical RN experience
  • An active designation as a Certified Care Manager (CCM). If no active designation as a CCM at hire date, must have the experience and qualifications to obtain certification within the first year of hire
  • 7 years of leadership experience in Government Contracts, Business Development, Management, Medical Management, and/or other relevant/related experience
  • 3 years of experience working with a government contract (TRICARE or VA)
  • Ability to integrate and coordinate content from various sources to establish deliverables for multiple stakeholders and hold others accountable for delivering
  • Ability to synthesize information from a variety of resources to present or address an issue or to answer a question
  • Ability to apply the principles of independent logical thinking to define problems, collect data, establish facts, draw valid conclusions, and make strategic recommendations
  • Excellent written and verbal communication skills at multiple levels

     

Preferred Qualifications

  • Graduate degree

Work at Home Requirements

To ensure Hybrid Office/Home associates’ ability to work effectively, the self-provided internet service of Hybrid Office/Home 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
  • Associates 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 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

#LI-JB2

 

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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$123,800 – $170,400 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

 

 

 

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