Become a part of our caring community and help us put health first
 

The NICU Care Manager (Field Care Manager, Nurse 2) will complete assessments in person and telephonically with the membership. This position evaluates high acuity member's needs and requirements to achieve and/or maintain optimal wellness. This position will facilitate interaction with resources appropriate for the care and well-being of NICU members. The NICU Care Manager’s work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

• Employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.
• Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.
• The NICU Care Manager will review, analyze, assess, and attest for medical complexity.
• Responsible for health risk assessments along the continuum of care for members.
• Candidate will assess the member, create individualized care plans, and attend interdisciplinary care team meetings.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Collaboration with internal and external providers or departments to meet the members needs.
• Meet requirements for contractual and regulatory compliance.
• Responsible for providing clinical oversight and support for care coaches providing specialized Case Management wrap around services and supports, maintaining a case load.
• Follows established guidelines/policies/procedures.

Use your skills to make an impact
 

Required Qualifications

• Must reside in Virginia; This role will be regionally based in one of the Commonwealth’s six regions: Tidewater, Central, Northern/Winchester, Western/Charlottesville, Roanoke/Alleghany, Southwest. This includes within 40 miles of adjacent states to Virginia.
• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
• Minimum 2 years of experience of in-home case/care management.
• Minimum 1 year of acute care experience working in a Neonatal Intensive Care Unit (NICU) to include experience with high/complex acuity.
• Knowledge of community health and social service agencies and additional community resources.
• Ability to travel to region-based facilities and homes for face-to-face assessments.
• Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport.
• Ability to work with minimal supervision within the role and scope.
• Ability to use a variety of electronic information applications/software programs including electronic medical records.
• Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
• Excellent keyboard and web navigation skills.
• Ability to work a full-time schedule
• This role is considered member facing and is part of Humana Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• This role is part of Humana's Driver Safety program and therefore requires an individual to has to have a valid state driver’s license and proof of 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.​

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Preferred Qualifications

• BSN Bachelor’s of Science in Nursing.
• 3+ years of in-home assessment and care coordination experience.
• 3+ years of experience in the Neonatal Intensive Care Unit (NICU) - strongly preferred
• Experience as a lactation consultant and/or IBCLC International Board Certified Lactation Consultant experience with health promotion, coaching and wellness.
• Previous managed care experience.
• Bilingual preferred (Spanish, Arabic, Vietnamese or other).
• Certification in Case Management.
• Motivational Interviewing Certification and/or knowledge.

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.<