Maternity Care Management Field Nurse

Humana • Louisiana, MO

1d • Hybrid

About The Position

Become a part of our caring community and help us put health first The Field Care Manager Nurse 2 assesses and evaluates 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 wellbeing of members. The Field Care Manager Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Maternity Field Care Management Nurse (Field Care Manager Nurse) assesses and evaluates 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 wellbeing of members. The Field Care Manager Nurse work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Field Care Manager 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. In this role you will report to the Manager of Care Management and be part of the Medicaid Maternity team. In this role you will: Uses a holistic, member-focused approach to engage members and families in recovery and wellness programs Conducts telephonic and in-person assessments to identify member needs and guide to appropriate resources Supports optimal health and wellbeing through regular monitoring and evaluation of progress Develops individualized care plans using clinical judgment and changes in health status Collaborates with providers and community services to ensure quality, cost-effective outcomes Coordinates services for physical health, social determinants of health, and additional benefits Facilitates communication across the care team, including PCP and care transitions Provides relevant resources to families for health and wellness support Submits incident reports as required Participates in health promotion and community events Use your skills to make an impact

Requirements

• Licensed Registered Nurse (RN) in the state of Louisiana without restrictions
• Minimum two (2) years of clinical experience in maternity, Labor & Delivery, L&D, maternal child
• Proficient in using electronic information systems and Microsoft Office tools (Word, Outlook, Excel) to document, communicate, and collaborate effectively with internal partners and members.
• Demonstrates strong keyboard and web navigation skills, provides clear narrative documentation, and builds rapport through exceptional communication and interpersonal abilities.
• Ability to work with minimal supervision within the role and scope with the ability to adapt care plan to change in member status.
• Willing to travel up to 75% of the time to see members
• To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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 required. Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates 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 associates 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
• Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs and requires approval.
• This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• Must be willing to travel at least 75% of the time within a 30-40 mile radius of your assigned region, to conduct field visits with members in your assigned area. Travel requirements may vary based on member tier level.
• This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are 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.
• Eligible mileage includes: Travel from your home to your first work location of the day. Travel between client or assignment locations during the workday. Travel from your final work location back to your home.

Nice To Haves

• Case Management Certification (CCM) or willingness to obtain within two (2) years of employment
• Understanding of the current state Maternal/Child Mortality Morbidity
• Basic Breastfeeding knowledge
• Experience working with Medicare, Medicaid and dual-eligible populations
• Field Case Management Experience
• Health Plan experience
• Knowledge of community health and social service agencies and additional community resources
• Experience with health promotion, coaching and wellness
• Motivational Interviewing experience

Responsibilities

• Uses a holistic, member-focused approach to engage members and families in recovery and wellness programs
• Conducts telephonic and in-person assessments to identify member needs and guide to appropriate resources
• Supports optimal health and wellbeing through regular monitoring and evaluation of progress
• Develops individualized care plans using clinical judgment and changes in health status
• Collaborates with providers and community services to ensure quality, cost-effective outcomes
• Coordinates services for physical health, social determinants of health, and additional benefits
• Facilitates communication across the care team, including PCP and care transitions
• Provides relevant resources to families for health and wellness support
• Submits incident reports as required
• Participates in health promotion and community events

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed