Field Care Manager RN

Field Care Manager Nurse (Physical Health)

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. The Field Care Manager uses a holistic, member-centered approach. This approach involves partnering with members and their families to identify needs, address barriers to care, and connect them with appropriate clinical, community, and social resources.

You will report to the Manager, Care Management and support members on the Medicaid Team.

The Field Care Manager Nurse identifies and mitigates barriers to care, facilitates coordination across settings, and promotes continuity of care to improve health outcomes.

You will:

• 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.
• Ensure members are progressing toward desired health outcomes through ongoing monitoring, reassessments, and evaluations.
• Provide clinical interventions through the creation and implementation of 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.
• You will cover either Region 2, this area includes the following Parishes: St. Francisville, Clinton, Bayou L'Ourse, Angola, Jackson, Baton Rouge, Addis, Bursly, Rosedale, Plaquenmine, Gonzales, Prairieville, Donaldsonville, Livonia, New Roades, Lettsworth.

Required Qualifications:

• Unrestricted Registered Nurse license in the state of Louisiana with 2 years of experience of 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.
• Must document clinical assessments and care activities electronically using mobile devices and digital health record systems while working in members' homes.
• Engage members and caregivers during in-home visits to conduct assessments, explain care plans, and support trust-based relationships.
• Autonomously work within the role and scope.
• Must 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:

• BSN
• 3+ years of experience
• Experience with health promotion, coaching and wellness
• 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.
• Travel from your home to your first work location of the day.
• Travel between client or assignment locations during the workday.
• Travel from your final work location back to your home.

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.

Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward you will receive a link to complete the Text Screening either by text on your mobile device or email.

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. For more information please visit: Louisiana Board of Ethics (la.gov)

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 $71,100 - $97,800 per year

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

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 at Humana.com and at CenterWell.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