Bilingual RN Care Manager

Humana International Group

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Puerto Rico
$56,900 - $78,200 / year
full-time
mid
Posted March 7, 2026
via himalayas

About This Role

Become a part of our caring community and help us put health first This is a remote, telephonic position, but you must live in Puerto Rico. The RN Care Manager uses clinical knowledge to assess and evaluate members' needs to achieve and maintain optimal wellness. They also guide members with chronic conditions toward and facilitate interaction with resources appropriate for their care and wellbeing. The Care Manager reports to a Manager of Care Management, and work assignments frequently require interpretation and independent determination of the appropriate courses of action. We require you to be bilingual in English/Spanish and will test you for both languages - Speaking/Reading/Writing included. Please submit your resume in English. The Care Manager, Telephonic Nurse employs a variety of strategies and techniques to manage a member's physical, environmental and psycho-social health issues. Responsibilities include the following: • Resolve barriers that hinder care. • Assess members with chronic conditions to determine their state of wellness and determine next steps, if any. • Ensure patient is progressing towards desired outcomes by managing patient care through assessments and evaluations. • May create member care plans. • Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. • Require minimal direction and receive guidance where needed. Follow established guidelines/procedures. Use your skills to make an impact Required Qualifications • Bachelor's Degree in Nursing (BSN) • Bilingual in English and Spanish (and able to pass language proficiency tests in both languages) • Active RN license without restrictions in Puerto Rico • Active RN license without restrictions in Florida • Affiliated with the CPEPR (Colegio de Profesionales de Enfermer a de Puerto Rico). • Prior clinical experience in adult acute care, skilled nursing, rehabilitation or discharge planning • Knowledge in Chronic Condition management (treatment, pharmacological treatment, signs and symptoms), including Diabetes, Hypertension, COPD, and chronic kidney disease. • Shift is 8-hours, plus 1 hour for lunch, from 8:30 AM to 5:30 PM EST and we adjust for Daylight Savings. • We adjust the work schedule according to business needs including necessary overtime and 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 only be used if leadership approves it. • Humana will provide Work-At-Home employees with telephone equipment appropriate to meet the requirements for their position. • 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. The Federal Government requires applicants to take the Interagency Language Rating (ILR) test. Additional Information As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring process. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. 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.$56,900 - $78,200 per yearThis 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 t...

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