RN, Field Care Manager

Join to apply for the RN, Field Care Manager role at Humana
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Join to apply for the RN, Field Care Manager role at Humana
.

This range is provided by Humana. Your actual pay will be based on your skills and experience—talk with your recruiter to learn more.

$71,100.00/yr - $97,800.00/yr

Become a part of our caring community and help us put health first. Humana Healthy Horizons in Virginia is looking for RN, Field Care Managers (Field Care Manager Nurse
2) who perform primarily face-to-face and telephonic assessments to adult and pediatric members.

• Manage a case load and complete assessments with members in their home or community-based setting, as well as telephonically.
• Provide clinical support and guidance, particularly for members with medical complexity.
• Develop and coordinate care plans ensuring that patients receive appropriate services to manage their health needs effectively.
• Address barriers to health care and advocate for optimal member outcomes.
• Review, assess, and complete medical complexity attestations and clinical oversights.
• Ensure members receive services in the least restrictive setting to achieve and/or maintain optimal well‑being by assessing their care needs.
• Develop and modify Individual Care Plans and involve applicable members of the care team in care planning (informal caregiver, coach, PCP, etc.).
• Support members and/or caregivers using an interdisciplinary approach to access social, housing, educational and other services, regardless of funding sources, to meet their needs.
• Collaborate with Community Health Workers (CHW), Housing Specialist and other internal and external agencies for health‑related social needs (HRSN).
• Serve as the primary point of contact for the interdisciplinary care team (ICT) and coordinate with the member, ICT participants, and outside resources to ensure the member’s needs are met.

• 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, pediatric 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 to maintain personal vehicle liability insurance. The vehicle insurance must meet the state or federal minimum required limits.

• 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 – able to speak, read and write in both languages without limitations and assistance.

• Workstyle:
  Field – This is a field position where employees…