RN, Field Care Manager

Humana • Opelousas, LA

2d • Hybrid

About The Position

The RN, Field Care Manager 2 (Physical Health) assesses and evaluates members’ 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. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. As a RN, Field Care Manager 2 (Physical Health) you will employ a comprehensive, member-focused approach to support individuals in managing physical, environmental, and psycho-social health challenges. You will help identify and address barriers to effective care, ensuring members receive the resources and support necessary for optimal wellbeing. You will report to the Manager of Care Management within the Louisiana Medicaid Team. Engage and empower members and their families by utilizing holistic strategies to support recovery, health maintenance, and participation in wellness programs. Conduct telephonic and in-person assessments to evaluate member needs, guiding them and their families toward appropriate resources to achieve and sustain their best possible health outcomes. Continuously monitor member progress, using regular assessments and evaluations to ensure advancement toward individualized care goals. Develop and implement personalized care plans based on clinical judgment, changes in member health status, psychosocial factors, and identified triggers, providing targeted clinical interventions. Collaborate with healthcare providers, community organizations, and services to facilitate quality, cost-effective care and support for members. Coordinate delivery of essential services, addressing physical health needs, social determinants of health, and additional value-added benefits to comprehensively support members. Facilitate communication and coordination across the interdisciplinary care team, including primary care providers, to ensure seamless transitions of care and integrated service delivery. Demonstrate an understanding of departmental, segment, and organizational strategies and objectives, aligning daily practices with broader operational goals. Document and submit incident reports observing organizational policies and regulatory requirements.

Requirements

• Candidates must reside within Louisiana Regions 1, 2, 3, 4, or 8
• Active, unrestricted Registered Nurse (RN) license in the state of Louisiana.
• Two (2) or more years of clinical experience working with diverse populations, including youth, adults, and geriatric populations.
• Knowledge of community health and social service agencies, as well as additional community resources.
• Experience using a variety of electronic information applications and software programs, including electronic medical records, with excellent keyboarding and web navigation skills and the ability to provide narrative documentation.
• Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
• Ability to work independently with minimal supervision, exercise sound judgment within the scope of the role, and proactively adapt care plans to meet changing member needs and circumstances.
• A separation of two (2) or more years from LDH is required for consideration.

Nice To Haves

• Bachelor’s degree in nursing (BSN).
• Certification in Case Management (CCM).
• Experience with health promotion, coaching and wellness.
• Previous care or case management experience.
• Managed Care Health Plan experience.
• Bilingual or multilingual (English, Spanish, Creole); with the ability to read, write, and speak in both languages with no limitations or assistance.

Responsibilities

• Engage and empower members and their families by utilizing holistic strategies to support recovery, health maintenance, and participation in wellness programs.
• Conduct telephonic and in-person assessments to evaluate member needs, guiding them and their families toward appropriate resources to achieve and sustain their best possible health outcomes.
• Continuously monitor member progress, using regular assessments and evaluations to ensure advancement toward individualized care goals.
• Develop and implement personalized care plans based on clinical judgment, changes in member health status, psychosocial factors, and identified triggers, providing targeted clinical interventions.
• Collaborate with healthcare providers, community organizations, and services to facilitate quality, cost-effective care and support for members.
• Coordinate delivery of essential services, addressing physical health needs, social determinants of health, and additional value-added benefits to comprehensively support members.
• Facilitate communication and coordination across the interdisciplinary care team, including primary care providers, to ensure seamless transitions of care and integrated service delivery.
• Demonstrate an understanding of departmental, segment, and organizational strategies and objectives, aligning daily practices with broader operational goals.
• Document and submit incident reports observing organizational policies and regulatory requirements.

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
• Mileage reimbursement for Travel

What This Job Offers

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