Bilingual Care Manager, Telephonic RN
Become a part of our caring community and help us put health first
This is a Work-At-Home position located in Puerto Rico. You must live in Puerto Rico for this position.The Care Manager, Telephonic Nurse works in a telephonic environment. They assess and evaluate members' needs and requirements to achieve and maintain an optimal wellness state. Using clinical knowledge, the Care Manager guides members with chronic conditions toward and facilitates interaction with resources appropriate for their care and wellbeing. The Care Manager, Telephonic Nurse's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
You must be fully bilingual in English/Spanish and will be required to pass a test for both languages - Speaking/Reading/Writing included. ***Please submit resume in English.
The Care Manager, Telephonic Nurse employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Responsibilities include the following:
- 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.
- May create member care plans.
- 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.
Use your skills to make an impact
Required Qualifications
- Active RN license without restrictions in Puerto Rico
- Active RN license without restrictions in Florida
- Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico).
- Prior clinical experience in adult acute care, skilled nursing, rehabilitation, OR discharge planning.
- Ability to work independently under minimum supervision and with a team.
- Able to work an 8-hour shift between 8:30 AM - 5:30 PM EST and adjusted for Daylight Savings
- (Work schedule can be adjusted according to business hours - necessary overtime and/or weekends)
Preferred Qualifications
- Health Plan experience
- Previous Case Management Experience
- Call center or triage experience
- Previous experience managing Medicare members.
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.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Humana will provide Work-At-Home 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 speaks with a member in a language other than Spanish 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.
Additional Information
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.
Scheduled Weekly Hours
40Pay 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.
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 veteran status. 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.
Average salary estimate
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Join Humana as a Bilingual Care Manager, Telephonic RN and become an essential part of our caring community! This remote position is an exciting opportunity for nurses who reside in Puerto Rico. In this role, you'll use your clinical expertise to assess and evaluate the healthcare needs of our members over the phone, guiding them through their wellness journeys. Your primary focus will be to assist individuals with chronic conditions, ensuring they access the right resources and receive the best possible care. You will create personalized care plans, tackle barriers to successful treatment, and continuously monitor patients to keep them on track for optimal health outcomes. You'll need to be fully bilingual in English and Spanish, as communication is key in delivering exceptional care to our diverse members. With varied assignments, you’ll have the chance to showcase your independent judgment and make impactful decisions in a supportive environment that prioritizes health first. Additionally, if you have prior experience in a health plan or case management, we want to hear from you! At Humana, we’re all about providing competitive compensation—ranging from $53,300 to $73,400 annually—and a benefits package that truly cares for you, including medical, dental, and vision coverage, as well as time off for personal rejuvenation. Ready to put your nursing skills to great use? Apply today and help us make a difference in our members’ lives!
Since 1961, Humana has been committed to helping people live healthy and happy. Our approach is simple—offer personalized care from people who care. We do this by listening to our members and creating solutions to help them reach the best version ...
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