RN, Field Care Manager (Maternal-Child Health)

Become a part of our caring community 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. The RN, Field Care Manager Nurse 2 (Maternal-Child Health) employs 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). Required 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. Preferred Qualifications 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. 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 for Travel: Mileage reimbursement is provided for work-related travel. Eligible mileage includes travel from your home to your first work location, travel between client or assignment locations during the workday, and travel from your final work location back to your home. 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. For more information please visit: Louisiana Board of Ethics (la.gov) Work at Home Requirements: 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 suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: 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 The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description Of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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. 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. Learn more about what we offer atHumana.comand atCenterWell.com. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. #J-18808-Ljbffr Humana