Field Care Manager RN

About the role

The Field Care Manager Nurse (Physical Health) plays a critical role in assessing and coordinating care to support members in achieving and maintaining health outcomes. This role involves a holistic, member-centered approach, working closely with members and their families to identify needs, address barriers to care, and connect them with appropriate clinical, community, and social resources.

Responsibilities

• Use a holistic, member-centric approach to engage and motivate members and their families through recovery, health, and wellness programs.
• Perform telephonic and face-to-face assessments to evaluate members' needs and support achievement and maintenance of wellness by connecting members and families to appropriate resources.
• Ongoing monitoring, reassessments, and evaluations to ensure members are progressing toward desired health outcomes.
• Create and implement individualized care plans based on clinical judgment, changes in physical or psychosocial health, and identified triggers.
• Collaborate with providers, caregivers, and community resources to promote high-quality, cost-effective outcomes.
• Coordinate delivery of needed services and support related to Physical Health, Social Determinants of Health, and value-added benefits.
• Partner across the transdisciplinary care team, including primary care providers, and support transitions of care.
• Demonstrate understanding of department, segment, and organizational strategies and operating goals, and how they align with related areas.
• Submit incident reports following organizational and regulatory requirements.

Requirements

• Unrestricted Registered Nurse license in the state of Louisiana with 2 years of experience in in-home case/care management.
• Experience working with all populations (youth, adult, geriatric).
• Knowledge of community health and social service agencies and additional community resources.
• Experience using a variety of electronic information applications/software programs including electronic medical records with excellent keyboard and web navigation skills and the ability to provide narrative documentation.
• Autonomously work within the role and scope.

Preferred Qualifications

• Bachelor of Science in Nursing (BSN).
• 3+ years of experience.
• Previous managed care experience.
• Bilingual — English, Spanish.
• Certification in Case Management.
• Motivational Interviewing Certification or knowledge.

Workstyle

Combination remote work at home and onsite/home member visits.

Travel, Driver's License, Transportation, Insurance

• You must be willing to travel. This travel will be at least 75% of the time within your assigned Region where you reside.
• 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.
• 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.
• Mileage reimbursement is provided for work-related travel.

Work at Home Guidance

• To Ensure Home Or Hybrid Home/Office Employees' Ability To Work Effectively, The Self-provided Internet Service Of Home Or Hybrid Home/Office Employees Must Meet The Following Criteria At Minimum, A Download Speed Of 25 Mbps And An Upload Speed Of 10 Mbps Is Required; Wireless, Wired Cable Or DSL Connection Is Required.
• Satellite, Cellular And Microwave Connection Can Be Used Only If Approved By Leadership.
• Employees Who Live And Work From Home In The State Of California, Illinois, Montana, Or South Dakota Will Be Provided A Bi-weekly Payment For Their Internet Expense.
• Humana Will Provide Home Or Hybrid Home/Office Employees With Telephone Equipment Appropriate To Meet The Business Requirements For Their Position/Job.
• Work From A Dedicated Space Lacking Ongoing Interruptions To Protect Member PHI / HIPAA Information.

Language Proficiency Testing

• Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency.

About Us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.