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, partnering 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.
• Reside in Louisiana and can work a full-time (40 hours minimum) flexible work schedule and travel to member's residence within 50 miles.

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.

Hours

We require the ability to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, and we may request over-time to meet our needs, which requires approval.

Screening

We consider this role patient facing and make it part of Humana's Tuberculosis (TB) screening program. If selected for this role, we will screen you for TB.

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.
• The purpose of this travel is to conduct field visits with members in your assigned area.
• Travel requirements may vary based on member tier level.
• 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.
• Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Additional Information

• Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity.
• A separation of two (2) or more years from LDH is required for consideration.