[Hiring] Field Care Manager Nurse @Humana

Role Description

The RN, Field Care Manager Nurse 2 (Maternal-Child 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.

• Employ a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues.
• Identify and resolve barriers that hinder effective care.
• Use a holistic, member-focused approach to engage members and families in recovery and wellness programs.
• Conduct telephonic and in-person assessments as needed to identify member needs and guide them to appropriate resources.
• Support optimal health and wellbeing through regular monitoring and evaluation of progress.
• Develop individualized care plans using clinical judgment and changes in health status.
• Collaborate with providers and community services to ensure quality, cost-effective outcomes.
• Coordinate services for physical health, social determinants of health, and additional benefits.
• Facilitate communication across the care team, including PCP and care transitions.
• Provide relevant resources to families for health and wellness support.
• Submit incident reports as required.
• Participate in health promotion and community events.
• Implement care management activities in accordance with contractual requirements and established guidelines, while ensuring compliance with updates and directives issued by the Louisiana Department of Health (LDH).

Qualifications

• Candidates must reside in Region 6, 7, or 8 of Northern Louisiana, including the following parishes: Avoyelles, Bienville, Bossier, Caddo, Caldwell, Catahoula, Claiborne, Concordia, De Soto, East Carroll, Franklin, Grant, Jackson, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Rapides, Red River, Richland, Sabine, Tensas, Union, Vernon, Webster, West Carroll, or Winn.
• An active licensed Registered Nurse (RN) in the state of Louisiana without restrictions.
• Two (2) or more years of clinical experience in maternal-child health, Labor & Delivery (L&D) and/or pediatrics.
• Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
• Ability to use a variety of electronic information applications/software programs including electronic medical records.
• Exceptional communication and interpersonal skills with the ability to quickly build rapport.
• Ability to work independently with minimal supervision, exercising sound judgment within role scope while proactively adapting care plans to meet changing member needs and circumstances.

Requirements

• Case Management Certification (CCM) or willingness to obtain within two (2) years of employment.
• Understanding of the current state Maternal/Child Mortality Morbidity.
• Basic Breastfeeding knowledge.
• Experience working with Medicare, Medicaid and dual-eligible populations.
• Field Case Management Experience.
• Managed Care Health Plan experience.
• Knowledge of community health and social service agencies and additional community resources.
• Experience with health promotion, coaching and wellness.
• Motivational Interviewing Experience.

Benefits

• Competitive 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 and many other opportunities.

Additional Information

• Workstyle: This position is primarily field-based; however, the designated work location is a remote home office when not conducting community or member visits.
• Work Schedule: Monday through Friday 8:00 AM to 5:00 PM CT, management may request overtime to meet business needs and requires approval.
• Travel: Up to 50% within the assigned Louisiana region to conduct face-to-face interactions with members, families, and providers based on member tier level. Additional travel may be required for community engagement activities and team meetings throughout Louisiana.
• Mileage reimbursement is provided for work-related travel.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
• Scheduled Weekly Hours: 40
• Pay Range: $71,100 - $97,800 per year. This job is eligible for a bonus incentive plan based upon company and/or individual performance.