RN Field Care Management Team Lead (HCBS & LTSS) Wayne & Macomb Counties

Humana • Chittenden, VT

3d • $71,100 - $97,800 • Remote

About The Position

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 Field Care Manager Nurse 2 (Team Lead) employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.

Requirements

• Active Michigan Registered Nurse (RN), Nurse Practitioner (NP), or Clinical Nurse Specialist (CNS) license in good standing with no disciplinary actions.
• Must reside in the State of Michigan (Wayne and Macomb Counties)
• Prior care management experience, including leading, mentoring, training, or supporting clinical team members.
• Strong knowledge of Home and Community-Based Services (HCBS), Long-Term Services and Supports (LTSS), Medicaid regulations, and person-centered planning principles.
• Experience with conducting Long-Term Services and Supports (LTSS) assessments, Medicaid regulations, and person-centered planning principles
• Experience providing in-home patient care, including care management, hospice, home health, or a comparable healthcare setting
• Experience working with adult populations, including chronic disease management and patient education
• Knowledge of community health resources, social service agencies, and care coordination services
• Proficiency with electronic health records (EHRs), electronic medical record (EMR) systems, and other healthcare technology applications
• Strong computer skills, including efficient keyboarding, internet research, and web-based navigation
• Intermediate to advanced proficiency in Microsoft Office applications, including Word, Outlook, and Excel
• Strong organizational, communication, and interpersonal skills with the ability to collaborate effectively across multidisciplinary teams

Nice To Haves

• Bachelor of Science in Nursing (BSN)
• Previous experience in a lead or supervisory role within a healthcare setting.
• 3-5 years of experience in in-home patient assessment, care coordination, and case management
• Demonstrated experience completing Demonstrated experience completing InterRAI Integrated Health Care (IHC) Assessments with a strong understanding of assessment methodology, care planning, and identification of member needs across clinical, functional, cognitive, and psychosocial domains.
• Proven experience conducting and documenting Nursing Facility Level of Care Determinations (NFLOCDs) in accordance with state Medicaid, LTSS, and regulatory requirements.
• Experience in health promotion, wellness coaching, and patient engagement strategies
• Previous experience working in a managed care environment
• Bilingual proficiency in Spanish, Arabic, or Chaldean Neo-Aramaic
• Certified Case Manager (CCM) or other case management certification
• Motivational Interviewing certification and/or demonstrated knowledge and application of Motivational Interviewing techniques

Responsibilities

• Partners closely with the Manager of Care Management to drive performance, identify and address barriers, and ensure daily operational excellence in alignment with organizational goals.
• Execute all principal duties of the Field Care Nurse when required, delegating responsibilities as appropriate to optimize team efficiency and effectiveness.
• Oversee daily assignment of Care Coordinators, Community Health Workers (CHW), and CMSA 2 personnel, balancing case load, referral volume, and geographic considerations to meet member needs and organizational goals.
• Proactively assist team members with assignment and case load management, adapting plans as necessary to support changing priorities and workload demands.
• Collaborate with nonclinical associates to facilitate research, conduct nonclinical assessments, address scheduling needs, and ensure comprehensive support for all Interdisciplinary Care Team (ICT) participants, including effective meeting coordination and communication updates.
• Conduct annual onsite visits for field-based associates (Care Coordinator/CHW) to support quality assurance initiatives and deliver targeted training.
• Review and address problems, including conducting onsite assessments as necessary to ensure issues are identified, analyzed, and resolved promptly and effectively.
• Contribute to the development and execution of MI HIDE program strategy and operational efficiency initiatives, actively participating in Experience & Optimization Team efforts.
• Serve as team preceptor and trainer, supporting onboarding, ongoing education, and professional development for associates.
• Act as team SME, providing real-time support to associates via team chat to troubleshoot issues and answer questions, fostering a collaborative and solutions-oriented team environment.

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, 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