Field Care Manager RN--Maternal-Child Health

Humana • Richmond, VA

1d • Hybrid

About The Position

Humana Healthy Horizons in Virginia is seeking a RN, Field Care Manager Nurse (Maternal-Health) who will assess and evaluate high acuity member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and well-being of members who are pregnant and postpartum. The RN, Field Care Manager Nurse (Maternal-Health) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action and requires travel throughout the community. Responsible for health risk assessments along the continuum of care for members. Assesses members, creates individualized care plans, and attends interdisciplinary care team meetings. 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 members are progressing towards desired outcomes by continuously monitoring their care through assessments and/or evaluations. 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. Collaborates with internal and external providers or departments to meet the member's needs. Meets requirements for contractual and regulatory compliance. Follows established guidelines/procedures. Use your skills to make an impact.

Requirements

• Must reside in the Central Region (Richmond Area) in the Commonwealth of Virginia and travel to see members in region-based facilities and homes for face-to-face assessments and interactions with members and/or families. In the counties/independent cities of Richmond City, Chesterfield County, Petersburg, Hannover County, Caroline County, Dinwiddie County, New Kent, King William, Richmond County.
• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
• 2 years of prior experience in health care and/or case management.
• 1 year of acute care experience working in obstetrics, women's care, labor and delivery, mother, baby, NICU and/or clinical triage.
• Knowledge of community health and social service agencies and additional community resources.
• Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel with the ability to use a variety of electronic information applications/software programs including electronic medical records.
• Excellent keyboard and web navigation skills.
• Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport.
• Ability to work with minimal supervision within the role and scope.
• Ability to travel to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.
• Self-provided internet service 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 required. Satellite, cellular and microwave connection can be used only if approved by leadership.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Valid state driver's license.
• Expected to maintain personal vehicle liability insurance.
• Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
• Must be screened for TB as this role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program.

Nice To Haves

• Bachelor's of Science in Nursing (BSN).
• 3+ years of experience.
• Lactation experience as a certified lactation consultant.
• Experience with health promotion, coaching and wellness.
• Previous managed care experience.
• Certification in Case Management (CCM).
• Motivational Interviewing Certification and/or knowledge.
• Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations or assistance.

Responsibilities

• Assess and evaluate high acuity member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and well-being of members who are pregnant and postpartum.
• Perform health risk assessments along the continuum of care for members.
• Assess members and create individualized care plans.
• Attend interdisciplinary care team meetings.
• Employ a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.
• Identify and resolve barriers that hinder effective care.
• Ensure members are progressing towards desired outcomes by continuously monitoring their care through assessments and/or evaluations.
• Collaborate with internal and external providers or departments to meet the member's needs.
• Meet requirements for contractual and regulatory compliance.
• Follow established guidelines/procedures.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level