RN, Field Care Manager (LTSS/ABD)

Humana Healthy Horizons in Virginia is seeking RN, Field Care Managers (Field Care Manager Nurse 2) to perform telephonic and face-to-face assessments and evaluations of the needs and requirements of our long-term services and support (LTSS) and aged, blind and disabled (ABD)member population. The RN, Field Care Manager supports achieving and/or maintaining optimal wellness by guiding members/families toward and facilitating interaction with resources appropriate for the care and well-being of members. They work assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Role Overview

This role involves meeting members in the field at their home or location of the member's choice, spending quality time assessing their goals, needs and barriers and then connecting our members with quality services to promote their ultimate well-being and drive person centered health outcomes.

• Reviews, analyzes, assesses, and attests for medical complexity.
• Develops member individualized care plans.
• Employs a variety of evidence-based strategies, approaches, and techniques to manage a member's physical, environmental, and psychosocial health.
• Identifies and resolves barriers that hinder effective care.
• Ensures member is progressing towards desired outcomes by continuously monitoring member care through comprehensive assessments and/or evaluations.
• Makes autonomous decisions, occasionally in ambiguous situations.
• Requires minimal direction and receives guidance where needed.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Follows established guidelines/procedures.

Required Qualifications

• Must reside in Richmond, Virginia area and be available to see members in the community
• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
• 2 years of prior experience in health care and/or case management.
• 1 year of experience working with individuals who are at risk for chronic medical conditions & high social needs (adult and pediatric populations).
• Knowledge of community health and social service agencies and additional community resources.
• Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel with the ability to use a variety of electronic information applications/software programs including electronic medical records. Excellent keyboard and web navigation skills.
• Exceptional communication and interpersonal skills with the ability to quickly build rapport.
• Ability to travel to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.

Preferred Qualifications

• Bachelor of Science in Nursing (BSN).
• Certification in Case Management (CCM).
• Previous managed care experience.
• Experience with in-home assessment and care coordination
• Experience with disease management, health promotion, coaching and wellness.
• Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. See "Additional Information" section for more information.

Additional Information

• Workstyle: Field - This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.
• Workdays and Hours: 40 hours a week - Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
• Travel: 50 - 75% field interactions with members, and their families and providers Richmond, VA area . May need to attend onsite meetings occasionally in Humana Healthy Horizons office in Glen Allen, VA.
• Driver Safety: 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.
• 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.
• Screening: This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• Language Assessment Statement: 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.

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

$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.