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

Humana Healthy Horizons in Virgina is seeking Long-Term Services and Support (LTSS) RN, Field Care Managers (Field Care Manager Nurse 2) who will perform telephonic and face-to-face assessments and evaluations of high acuity Home and Community Based (HCBS), Private Duty Nursing, or Ventilated member needs and requirements. RN, Field Care Managers (Field Care Manager Nurse 2) 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. The RN, Field Care Managers (Field Care Manager Nurse 2) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

This role involves meeting members in the field at their home, Nursing Facility (NF) 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, assess, and attests for medical complexity.
• 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.
• Develops member individualized care plans. 
• 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.

Use your skills to make an impact
 

Required Qualifications

• Must reside in the Commonwealth of Virginia or within a 20-mile radius from Virginia in a bordering state/district (Washington DC, MD, WV, KY, TN & NC).
• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
• Two (2) years of experience of in-home case/care management.
• One (1) year of experience working with individuals who meet the Cardinal Care Priority Population criteria (adult and pediatric populations at risk for chronic medical conditions & high social needs).
• One (1) year of experience working with member populations who receive private duty nursing services or life-sustaining ventilator dependent members.
• 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.
• 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 work with minimal supervision.
• 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.
• Must be able to travel throughout Medicaid regions in the Commonwealth of Virginia.
• 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.

Preferred Qualifications

• Bachelor of Science in Nursing (BSN).
• Certification in Case Management (CCM).
• Motivational Interviewing Certification and/or knowledge.
• 3-5 years of in-home assessment and care coordination experience.
• Experience with disease management, health promotion, coaching and wellness.
• Previous managed care experience.
• Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitati