Remote RN – Nursing Educator 2 (UM, CM, Pre-Certs, Compliance), Multiple Locations

Humana

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Location: FL
Location Type: Remote
Additional Location: AL; AR; CA; CO; CT; DE; GA; ID; IL; IN; IA; KS; KY; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NV; NC; ND; OH; OK; OR; PA; SC; SD; TN; VT; VA; WA; WI; WY;
Schedule: Full_time
Req: R-333941

About this job

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

The RN, Nursing Educator 2 plans, directs, coordinates, evaluates, develops, delivers training and education programs for professional nursing personnel. The RN, Nursing Educator 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

 

The RN, Nursing Educator 2 develops educational goals and plans for new associate orientation, ongoing training, and professional development.  Training programs may include, but not be limited to, Pre-Certification, Care Management, Utilization Management, and/or Compliance.

  • Plans, coordinates, and implements training programs for Health Services associates, including but not limited to face to face instructor-led and virtual instructor-led training, Nursing Orientation, Systems, MCG and EncoderPro training.
  • Develops curriculum, training agenda, presentations, job aids, case studies, and activities for new nurses.
  • Facilitates process update training for UM nurses.
  • Develops programs to improve UM nurse competencies (critical thinking skills, interpreting criteria, communication with providers to facilitate optimal care, documentation of the review process).
  • Creates an environment that is conducive to learning and exchanging information, engages the learner, and produces the desired outcomes
  • Monitors quality of work (new hires & existing nurses); provides remediation where necessary.
  • Serves as a clinical resource & supports Nursing associates.
  • 25% of time works cases to keep current, assist team with inventory and identify appropriate cases for training.
  • 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

  • Bachelor’s Degree
  • RN licensed in the state of Florida without restrictions -or- compact state license.
  • Over 1 year of Utilization Management (prior authorization) experience working in managed care settings/environments (health plan).
  • Experience with EncoderPro
  • 2 years of nursing education or preceptor experience
  • Advanced Proficiency with MCG/Interqual criteria, CMS guidelines and clinical review processes.
  • Intermediate to advanced proficiency in MS Office applications specifically in Outlook, Word, Excel and PowerPoint.
  • Excellent written and verbal communication skills.

Preferred Qualifications

  • Master’s degree in one of the following areas: Learning & Development, Nursing, Nursing Informatics, Human Resources, Organizational Design.
  • Proficiency in MS Teams and One Note.
  • Experienced with CSC and CWAS systems.
  • MCG Certification.
  • Understanding of curriculum design and adult learning principles.
  • Learning facilitation experience: Face-to-face & Virtual (Zoom); Data management/computer systems training.

 

Additional Information

  • Typical Days/Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
  • Work Location: Remote

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 recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees 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 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

 

 

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

 

$69,800 – $96,200 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

About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties.

 

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our 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.