The Inpatient Case Manager functions as the patient advocate for FPG patients who have been admitted to an alternate level of care. These levels of care include but are not limited to hospitals, tertiary care centers, LTAC’s, SNF’s, and Inpatient Rehab Centers. The Inpatient Case Manager also acts as a representative or liaison for the FPG PCP and the Inpatient Clinical Team. The position works closely with the health plan case managers, hospital case managers, outpatient Care Coaches, FPG Providers, and Hospitals, to make sure the patient’s care is appropriate, efficient, and focused.
This role is M-F 8am – 5pm. You will travel to several S.N.F visit onsite patients and get them ready to transition to home in the West Orlando region.
The Inpatient Case Manager 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. 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.
- Registered Nurse
- Case Management Experience
- Must understand CMS guidelines
- Experience working with the senior population
- Knowledge of community health and social service agencies and additional community resources
- Exceptional communication and interpersonal skills with the ability to quickly build rapport.
- Must have a good understanding of the mechanism of disease, treatment options, and appropriateness criteria
- Must be comfortable working in a hospital or post- acute setting
- Ability to work with minimal supervision within the role and scope
- Ability to use a variety of electronic information applications/software programs including electronic medical records
- Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel
- Ability to work a full-time (40 hours minimum) work schedule
- This role is a part of Humana's Driver Safety program and therefore requires and individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,00 limits.
- This role is considered patient facing and is part of Humana At Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
- Must have reliable transportation.
- If selected for this role, you will be required to complete and pass background check/investigation for AHCA compliance
- Experience with health promotion, coaching and wellness
- Certification in Case Management
- Health Plan and Medicare experience
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.
Interview Format: As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire assessment.
Scheduled Weekly Hours