The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.
The Manager, 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 resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
+ Registered Nurse from an accredited institution who have actively practiced nursing in a state, jurisdiction or territory of the US for 2 of the preceding 3 years without having license acted against by the licensing authority of any jurisdiction
+ Active RN license without restrictions in Puerto Rico and/or Active RN license in Florida, USA.
+ Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico) IF you have an Active RN license in FL, USA, this is not a mandatory requirement
+ If you do not have an active FL RN license:
+ You need to have 2 consecutive years of experience as RN of the preceding 3 years(no gaps in employment) and apply for FL RN license endorsement as soon as employment offer is accepted. OR,
+ If you have under 2 yrs. experience as RN and have attended to one of the accredited schools in PR, must successfully complete and pass the NCLEX exam within 60 days of employment
+ 2+ years of clinical experience
+ Proficiency in analyzing and interpreting data trends.
+ Progressive business consulting and/or operational leadership experience
+ Minimum of 3+ years of experience managing large group of employees (at least from 15 - 20)
+ 3+ years of previous management/supervisor level experience managing a fast pace operational demands and timeframes
+ Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
+ Fully Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. If selected for the position, you will be required to take a Language proficiency Assessment in English/Spanish. See Additional Information on testing
+ Master's degree or advanced degree in nursing or business health field
+ Previous experience working in a managed care field
***Please submit resume in English
+ Address: Professional Office Park POP V, Tower 3, 7th floor, Oriental Bank Building 997 San Roberto St. San Juan, PR 00926
+ Training: 3- 4weeks
+ Schedule: 8:00 AM - 6:00 PM (Adjust work schedule according to business hours, overtime and/or weekends)
+ 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.
+ Direct Reports: 15 - 20 Associates
+ Travel: N/A
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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