RN, Field Care Manager

Humana Inc.•Salem, VA

68d•Remote

About The Position

Humana Healthy Horizons in Virginia is looking for RN, Field Care Managers (Field Care Manager Nurse 2) who performs primarily face to face and telephonic assessments to adult and pediatric members. The RN, Field Care Manager (Field Care Manager Nurse 2) will evaluate member's needs to achieve and/or maintain optimal wellness. This position employs a variety of strategies, approaches, and techniques to manage a member's health issues and identifies and resolves barriers that hinder effective care. They ensure members are progressing towards desired outcomes by continuously monitoring care through use of assessment, data, conversations with member, and active care planning. The RN, Field Care Manager (Field Care Manager, Nurse 2) understands professional concepts, regulations, strategies, and operating standards. They make decisions regarding work approach/priorities and follows direction.

Requirements

Applicants must reside in one of the following counties or independent cities in Virginia: Roanoke, Roanoke City, Salem, Montgomery, Craig, Botetourt, Bedford, Floyd or Franklin.
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 directly with individuals who meet the Cardinal Care Priority Population criteria (adults, pediatrics populations at risk for chronic medical conditions and high social needs).
Strong advocate and respect for members at all levels of care.
Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook.
Ability to use a variety of electronic information applications/software programs including electronic medical records.
Exceptional oral and written communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.
Ability to work with minimal supervision within the role and scope.
Ability to work a full-time schedule.
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.
Ability to travel to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.
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.â¯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.

Nice To Haves

Prior experience with Medicare, Medicaid and dual eligible populations.
Bachelor's Degree Nursing (BSN).
Case Management Certification (CCM).
Experience with health promotion, coaching and wellness.
Knowledge of community health and social service agencies and additional community resources.
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. See "Additional Information" section for more information.

Responsibilities

Responsible for managing a case load and completing assessments with members in their home or community-based setting, as well as telephonically.
Provides clinical support and guidance, particularly for members with medical complexity.
Develops and coordinates care plans ensuring that patients receive appropriate services to manage their health needs effectively.
Addresses barriers to health care and advocating for optimal member outcomes.
Reviews, assesses, and completes medical complexity attestations and clinical oversights.
Ensures members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs.
Develops and modifies Individual Care Plan and involve applicable members of the care team in care planning (Informal caregiver, coach, PCP, etc.).
Focuses on supporting members and/or caregivers utilizing an interdisciplinary approach in accessing social, housing, educational and other services, regardless of funding sources to meet their needs.
Collaborates with Community Health Workers (CHW), Housing Specialist and other internal and external agencies for health-related social needs (HRSN).
Primary point of contact for the interdisciplinary care team (ICT and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member's needs are met.

Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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.

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