RN, Field Care Manager (LTSS/ABD)

Humana • Alexandria, VA

2d • Remote

About The Position

Humana Healthy Horizons in Virginia is seeking RN, Field Care Managers to perform telephonic and face-to-face assessments and evaluations of the needs and requirements of our long-term services and support (LTSS) and aged, blind and disabled (ABD) member population. The RN, Field Care Manager supports achieving and/or maintaining optimal wellness by guiding members/families toward and facilitating interaction with resources appropriate for the care and well-being of members. They work assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action. This role involves meeting members in the field at their home or location of the member's choice, spending quality time assessing their goals, needs and barriers and then connecting our members with quality services to promote their ultimate well-being and drive person centered health outcomes. Reviews, analyzes, assesses, and attests for medical complexity. Develops member individualized care plans. Employs a variety of evidence-based strategies, approaches, and techniques to manage a member's physical, environmental, and psychosocial health. Identifies and resolves barriers that hinder effective care. Ensures member is progressing towards desired outcomes by continuously monitoring member care through comprehensive assessments and/or evaluations. Makes autonomous decisions, occasionally in ambiguous situations. Requires minimal direction and receives guidance where needed. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Follows established guidelines/procedures.

Requirements

• Must reside in Northern Virginia region (NOVA area)
• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
• Two (2) years of prior experience in health care and/or case management.
• One (1) year of experience working with individuals who meet the Cardinal Care Priority Population criteria (adult and pediatric populations at risk for chronic medical conditions & high social needs).
• Knowledge of community health and social service agencies and additional community resources.
• Intermediate to advanced computer skills and experience with Microsoft Office
• Ability to use a variety of electronic information applications/software programs including electronic medical records.
• Excellent keyboard and web navigation skills.
• Exceptional communication and interpersonal skills with the ability to quickly build rapport.
• Ability to work with minimal supervision.
• Ability to work a full-time schedule.
• Valid state driver's license.
• Maintain personal vehicle liability 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.

Nice To Haves

• Bachelor of Science in Nursing (BSN).
• Certification in Case Management (CCM).
• Previous managed care experience.
• Motivational Interviewing Certification and/or knowledge.
• 3-5 years of in-home assessment and care coordination experience.
• Experience with disease management, health promotion, coaching and wellness.
• Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance.

Responsibilities

• Perform telephonic and face-to-face assessments and evaluations of the needs and requirements of LTSS and ABD member population.
• Support achieving and/or maintaining optimal wellness by guiding members/families toward and facilitating interaction with resources appropriate for the care and well-being of members.
• Review, analyze, assess, and attest for medical complexity.
• Develop member individualized care plans.
• Employ a variety of evidence-based strategies, approaches, and techniques to manage a member's physical, environmental, and psychosocial health.
• Identify and resolve barriers that hinder effective care.
• Ensure member is progressing towards desired outcomes by continuously monitoring member care through comprehensive assessments and/or evaluations.
• Make autonomous decisions, occasionally in ambiguous situations.
• Work with minimal supervision.
• Work a full-time schedule.
• Be screened for TB as part of Humana's Tuberculosis (TB) screening program.
• Travel to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.
• Maintain personal vehicle liability insurance.

Benefits

• Medical benefits
• Dental benefits
• 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 disability
• Long-term disability
• Life insurance

What This Job Offers

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