RN Field Care Manager – Medicaid HCBS/LTSS

Job not on LinkedIn

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • 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.

📋 Description

• Assess members’ needs and help members and families access appropriate resources to achieve or maintain optimal health and well-being • Use strategies to address members’ physical, environmental, and psychosocial health needs • Manage a caseload and complete member assessments in home, community-based, and telephonic settings • Provide clinical support and guidance, particularly for members with complex medical needs • Develop and coordinate care plans to ensure appropriate services • Address barriers to healthcare and advocate for optimal member outcomes • Review, evaluate, and complete medical complexity attestations and clinical oversight activities • Assess care needs to ensure services are provided in the least restrictive setting • Develop and update Individual Care Plans with care team members, informal caregivers, coaches, and primary care providers • Help members and caregivers access social, housing, educational, and other services • Serve as primary contact for the Interdisciplinary Care Team (ICT) • Coordinate with members, ICT participants, and external resources • Conduct comprehensive InterRAI Integrated Health Care (IHC) assessments • Conduct Nursing Facility Level of Care Determinations (NFLOCDs) • Support accurate eligibility decisions and person-centered care planning • Ensure compliance with state Medicaid, LTSS, HCBS waiver, and regulatory requirements • Travel 75%–90% within Wayne and/or Macomb Counties for in-home visits

🎯 Requirements

• Must reside in Michigan, specifically Wayne or Macomb Counties • Active Michigan license as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN), including Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS), with no disciplinary actions • Experience with Home and Community-Based Services (HCBS) and waiver programs • 2+ years of experience in healthcare and/or case management • Experience conducting Long-Term Services and Supports (LTSS) assessments • Experience working with Medicaid regulations • Experience applying person-centered planning principles • Experience collaborating with interdisciplinary teams, providers, members, and caregivers to complete comprehensive assessments and recommend appropriate services • Ability to maintain timely, accurate, and compliant documentation in accordance with organizational, state, and federal requirements • Knowledge of community health, social service agencies, and community resources • Ability to use electronic information systems and software programs, including electronic medical records (EMRs) • Excellent keyboarding and web navigation skills • Intermediate to advanced computer skills, including Microsoft Word, Outlook, and Excel • Valid state driver’s license and personal vehicle liability insurance • Must complete TB screening • Bachelor of Science in Nursing (BSN) preferred • Experience completing InterRAI Integrated Health Care (IHC) assessments preferred • Experience conducting and documenting Nursing Facility Level of Care Determinations (NFLOCDs) preferred • Experience in health promotion, coaching, and wellness preferred • Previous experience in managed care preferred

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental, and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Mileage reimbursement for eligible travel • Self-provided internet requirements for home or hybrid home/office employees • Occasional travel to Humana offices for training or meetings