Job Description

Field Care Manager Nurse 2

The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Field Care Manager Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

How we value you!

• Competitive Pay, including eligibility for annual performance-based bonus
• Employee Referral Program

The Field Care Manager Nurse employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psychosocial health needs.

• Must reside in Michigan with the ability to drive to Wayne and/or Macomb Counties.
• This position is based out of a home office and requires traveling 7590% of the time within an assigned area in Wayne and/or Macomb County to conduct in-home visits with Medicare/Medicaid members.

Position Responsibilities:

• The RN Field Care Manager will be responsible for managing a caseload and completing assessments with members in their home or community-based setting, as well as telephonically.
• Provides clinical support and guidance, particularly for members with medical complexity. Helps develop and coordinate care plans, ensuring that members receive appropriate services to manage their health needs effectively. Addresses barriers to care and advocates for optimal member outcomes.
• Reviews, assesses, and completes medical complexity attestations and clinical oversight activities.
• Ensures members receive services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs.
• Develops and modifies the Individual Care Plan and involves applicable members of the care team (informal caregiver, coach, PCP, etc.) in the care-planning process.
• Focuses on supporting members and/or caregivers using an interdisciplinary approach to access social, housing, educational, and other servicesregardless of funding sourceto meet identified needs.
• Serves as the primary point of contact for the Interdisciplinary Care Team (ICT) and is responsible for coordinating with the member, ICT participants, and external resources to ensure the member's needs are met.

Required Qualifications:

• Must reside in the state of Michigan (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 action
• 2+ years' experience in Health Care and/or Case Management
• Ability to travel to homes and community settings for face-to-face assessments
• Experience working with the adult population, disease management.
• Knowledge of community health and social service agencies and additional community resources
• Ability to use a variety of electronic information applications & software programs including electronic medical records
• Excellent keyboard and web navigation skills
• Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel

Preferred Qualifications:

• BSN
• Experience with in home assessment and care coordination experience
• Experience with health promotion, coaching and wellness
• Experience with Medicaid Long Term Care
• Previous managed care experience
• Bilingual- Spanish, Arabic or Chaldean Neo-Aramaic
• Certification in Case Management
• Motivational Interviewing Certification and/or knowledge

Additional Information:

• Schedule/Time Zone: Monday through Friday, 8:30 AM 5:00 PM Eastern Time Zone
• Work Location: Michigan (Wayne and Macomb Counties)
• Work Style: Field
• Travel Requirements: 75%- 90% travel within Wayne and/or Macomb Counties, MI)

Work-at-Home (WAH) Internet Statement: 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.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

TB Statement: 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.

Driving Statement: 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.

Eligible mileage includes:

• Travel from your home to your first work location of the day.
• Travel between client or assignment locations during the workday.
• Travel from your final work location back to your home.

Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Language Assessment Statement: Any Humana employee 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.

Referral Bonus Information: This requisition is not eligible for a referral bonus.

About us: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

Equal Opportunity Employer: It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act

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