RN, Field Care Manager - Southwest Region, Virginia - Middlesboro Kentucky

Company: Humana
Location: Middlesboro, Kentucky
Posted On: 05/03/2025

Become a part of our caring community and help us put health first
Humana Healthy Horizons in Virginia is seeking a RN, Field Care Manager Nurse 2 (Maternal-Health) who will assess and evaluate high acuity 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 well-being of members who are pregnant and postpartum. The RN, Field Care Manager Nurse 2 (Maternal-Health) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Earn a $5,000 hiring bonus! $2,000 is paid after 6 months (180 days) of employment and $3,000 is paid after 1 year (365 days) of employment. You must be employed until those dates to be eligible to receive the payment.

• Responsible for health risk assessments along the continuum of care for members.
• Assesses members, creates individualized care plans, and attends interdisciplinary care team meetings.
• 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 members are progressing towards desired outcomes by continuously monitoring their care through assessments and/or evaluations.
• 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.
• Collaborates with internal and external providers or departments to meet the member's needs.
• Meets requirements for contractual and regulatory compliance.
• Follows established guidelines/procedures. Use your skills to make an impact
  Required Qualifications
  • Must reside in Southwest Region in the Commonwealth of Virginia in the counties/independent cities of Lee, Scott, Washington, Bristol, Russell, Norton, Wise, Buchanan, Dickenson, Tazewell, Smyth, Bland, Grayson, Gala, Wythe, Carroll County or within a 20-mile radius from the region in a bordering state (TN, KY)
  • 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.
  • Minimum one (1) year of acute care experience working in obstetrics, women's care, labor and delivery, mother, baby, NICU and/or clinical triage.
  • Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
  • Knowledge of community health and social service agencies and additional community resources.
  • 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.
  • Excellent keyboard and web navigation skills.
  • 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.
  • Ability to travel to region-based facilities and homes for face-to-face assessments.
  • 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's of Science in Nursing (BSN).
    • 3-5 years of in-home assessment and care coordination experience.
    • Lactation experience, preferably as a certified lactation consultant.
    • Experience with health promotion, coaching and wellness.
    • Previous managed care experience.
    • Certification in Case Management (CCM).
    • Motivational Interviewing Certification and/or knowledge.
    • Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations or assistance. See "Additional Information" for more information. Additional Information
      • Workstyle: This is a remote position that will require you to travel.
      • Travel: 50 - 75% region-based travel to meet with members, their families and providers. May need to attend occasional onsite meetings in Humana Healthy Horizons office in Glen Allen, VA.
      • Workdays and Hours: Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST).
      • Language Assessment Statement: Any Humana associate 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. 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.
        • 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. 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.
          
          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
          
          The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
          $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.
          Description of Benefits
          
          Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.
          
          About us
          Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.
          
          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 and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
          
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