RN, Field Care Manager – Adults and Pediatrics

Yesterday

⚔️ Virginia – Remote

Although this job is listed in Virginia, this company may be open to hiring remote in other states.

💵 $71.1k - $97.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

🦅 H1B Visa Sponsor

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Humana

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Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

📋 Description

• perform primarily face to face and telephonic assessments to adult and pediatric members • evaluate member's needs to achieve and/or maintain optimal wellness • employ a variety of strategies, approaches, and techniques to manage a member's health issues and identify and resolve barriers that hinder effective care • ensure members are progressing towards desired outcomes by continuously monitoring care through use of assessment, data, conversations with member, and active care planning • manage a case load and complete assessments with members in their home or community-based setting, as well as telephonically • provide clinical support and guidance, particularly for members with medical complexity • develop and coordinate care plans ensuring that patients receive appropriate services to manage their health needs effectively • address barriers to health care and advocate for optimal member outcomes • review, assess, and complete medical complexity attestations and clinical oversights • ensure members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs • develop and modify Individual Care Plan and involve applicable members of the care team in care planning (Informal caregiver, coach, PCP, etc.) • focus on supporting members and/or caregivers utilizing an interdisciplinary approach in accessing social, housing, educational and other services, regardless of funding sources to meet their needs • collaborate with Community Health Workers (CHW), Housing Specialist and other internal and external agencies for HRSN needs • be the primary point of contact for the ICT and responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met

🎯 Requirements

• Must reside in the Commonwealth of Northern Virginia • Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action • Two (2) years of prior experience in health care and/or case management • One (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria (adults, pediatrics populations at risk for chronic medical conditions and high social needs) • Strong advocate and respect for members at all levels of care • Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook • Ability to use a variety of electronic information applications/software programs including electronic medical records • Exceptional oral and written communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders • Ability to work with minimal supervision within the role and scope • Ability to work a full-time schedule

🏖️ Benefits

• 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 • many other opportunities