Humana is seeking an RN Care Manager Lead to guide a team of nurses in delivering coordinated, member-centered care. In this role, you will oversee complex care management activities, complete clinical assessments, develop holistic care plans, and coordinate services across providers, facilities, and community resources. You will mentor and schedule RN Care Managers, monitor caseloads and quality metrics, and use data and clinical judgment to reduce hospitalizations and improve health outcomes. The role collaborates closely with physicians, social workers, and pharmacists to ensure regulatory compliance and an excellent member experience. Responsibilities Lead and mentor RN care managers to achieve quality and productivity goals Perform comprehensive clinical and psychosocial assessments for members Develop and update individualized, holistic care plans Coordinate care across physicians, hospitals, post-acute and community resources Monitor clinical outcomes and intervene to reduce avoidable hospitalizations Use care management systems and data to track caseloads and quality metrics Ensure compliance with regulatory, accreditation, and Humana policies Collaborate with interdisciplinary teams including social work and pharmacy Educate members and families on conditions, medications, and self-management Participate in process improvement and best-practice implementation Required Skills Care management and complex case management Clinical assessment and triage Care plan development and coordination Knowledge of Medicare and Medicaid regulations Population health and chronic disease management Use of care management and EMR systems Data interpretation and quality metrics tracking Interdisciplinary team collaboration Member and family education Leadership and staff mentoring