RN, Field Care Manager (LTSS/ABD)

$71,100 - $97,800 / year

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

Humana Healthy Horizons in Virginia is seeking RN, Field Care Managers to perform telephonic and face-to-face assessments and evaluations of the needs and requirements of our long-term services and support (LTSS) and aged, blind and disabled (ABD)member population. The RN, Field Care Manager 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. They work assignments that 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 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, assesses, and attests for medical complexity.
Develops member individualized care plans.
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.
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 Virginia (NOVA area)
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.
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).
Knowledge of community health and social service agencies and additional community resources.
Intermediate to advanced computer skills and experience with Microsoft Office
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.
Ability to work a full-time schedule.
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 and interactions with members and/or families.
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).
Previous managed care experience.
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.
Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. See "Additional Information" section for more information.

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.
Travel: 50 - 75% field interactions with members, and their families and providers. May need to attend onsite meetings occasionally 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

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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