RN, Field Care Manager; Adults and Pediatrics

RN, Field Care Manager (Adults & Pediatrics)

Humana Healthy Horizons in Virginia is looking for RN Field Care Managers to perform face‑to‑face and telephonic assessments for adult and pediatric members. The manager will evaluate member needs, develop and coordinate care plans, and provide clinical guidance for members with medical complexity.

Base Pay Range: $71,100 – $97,800 per year

• Manage a case load and complete assessments with members in their home or community‑based setting, and telephonically.
• Provide clinical support and guidance for members with medical complexity.
• Develop and coordinate care plans ensuring appropriate services.
• 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 optimal well‑being.
• Develop and modify Individual Care Plans and involve applicable members of the care team.
• Support members and caregivers using an interdisciplinary approach to access social, housing, educational services.
• Collaborate with Community Health Workers, Housing Specialists, and other agencies for HRSN needs.
• Primary point of contact for the ICT and coordinate resources to meet member’s needs.

• Must reside in the Commonwealth of Northern Virginia.
• Active Registered Nurse (RN) license in Virginia without disciplinary action.
• Two years of prior health care or case management experience.
• One year working directly with individuals meeting the Cardinal Care Priority Population criteria.
• Strong advocate for members and respect for all levels of care.
• Intermediate to advanced computer skills with Microsoft Office.
• Experience with electronic medical records.
• Exceptional oral and written communication skills.
• Ability to work with minimal supervision.
• Ability to work a full‑time schedule.

• Experience with Medicare, Medicaid and dual‑eligible populations.
• Bachelor’s Degree in Nursing (BSN).
• Case Management Certification (CCM).
• Experience with health promotion, coaching, and wellness.
• Knowledge of community health and social service agencies.
• Bilingual or multilingual proficiency (English/Spanish, Arabic, Vietnamese, Amharic, Urdu or others). Must speak, read, and write both languages without limitations.

• Workstyle:
  Field – core duties performed at non‑company locations.
• Travel: 50-75% field interactions; occasional onsite meetings in Glen Allen, VA.
• Workdays & hours:
  Monday–Friday, 8:00 a.m.–5:00 p.m. EST.

To apply, submit your resume and cover letter through Humana’s secure portal.