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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient assessment, care planning, and resource navigation while ensuring compliance with HIPAA regulations. Proficient in critical thinking and bilingual communication to effectively support diverse member needs.
Highest-signal resume keywords
Licensed Registered Nurse (RN)Clinical Acute Care ExperienceBilingual in English/SpanishCritical Thinking SkillsCertified Case Manager (CCM)
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Patient AssessmentCare PlanningCase ManagementDischarge PlanningHealth PromotionCoachingWellness StrategiesKnowledge of Community HealthNavigating Multiple SystemsMonitoring Patient Care
Soft Skills
Interpersonal CommunicationProblem SolvingEmpathyFlexibilityTeam Collaboration
Tools & Technologies
Telephonic Communication SystemsData Assessment ToolsHealth Information Systems
Certifications & Qualifications
Licensed Registered Nurse (RN)Certified Case Manager (CCM)
Industry Keywords
HIPAA ComplianceManaged CareMedicareMedicaidCommunity Resources
About the role
Key responsibilities & impact- Assess and evaluate members' needs and requirements in a telephonic environment
- Guide members and families toward appropriate care and wellbeing resources
- Facilitate interaction with resources supporting members' care and wellbeing
- Employ strategies, approaches, and techniques to manage members' physical, environmental, and psychosocial health issues
- Identify and resolve barriers hindering effective care
- Continuously monitor patient care using assessments, data, conversations with members, and active care planning
- Ensure patients progress toward desired outcomes
- Navigate multiple systems and apply critical thinking to determine appropriate courses of action
- Work Monday–Friday, 8:00am–5:00pm CST, with occasional scheduling flexibility to accommodate member needs
- Travel occasionally to Humana offices for training or meetings
Requirements
What you’ll need- Licensed Registered Nurse (RN) in the state of Illinois with no disciplinary action or ability to obtain IL RN licensure
- Minimum of 3 years of clinical acute care experience as a licensed RN
- Bachelor's degree in a health-related field
- Bilingual in English/Spanish; must be able to speak, read, and write in both languages without limitations or assistance
- Ability to navigate multiple systems
- Critical thinking skills
- Ability to meet work-at-home requirements, including a minimum 25 Mbps download speed and 10 Mbps upload speed
- Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information
- Preferred: Bachelor's degree in Nursing (BSN)
- Preferred: Experience with case management, discharge planning, and patient education for adult acute care
- Preferred: Managed care experience
- Preferred: Certified Case Manager (CCM)
- Preferred: Prior experience with Medicare & Medicaid recipients
- Preferred: Experience with health promotion, coaching, and wellness
- Preferred: Knowledge of community health and social service agencies and additional community resources
- Applicants must complete the Interagency Language Rating (ILR) test
Benefits
Comp & perks- Bonus incentive plan based upon company and/or individual performance
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Work-from-home arrangement