Field Care Manager Nurse 2 ARTS

$71,100 - $97,800 / year

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

The ARTS Care Manager (Field Care Manager, Behavioral Health 2) performs primarily face to face and telephonic assessments with members with substance use disorders (SUD). The ARTS Care Manager serves as the primary point of contact. providing integrated care to ensure members receive timely, high-quality, and coordination services that meet their unique needs. This position employs a variety of strategies, approaches, and techniques to manage a member's health issues and identifies and resolves barriers that hinder effective care. Through a holistic, person-centered approach, the ARTS Care Manager remains dedicated to enhancing behavioral health outcomes, increasing resiliency and recovery, reducing care gaps, and supporting Virginia’s Medicaid population with comprehensive, integrated substance use care management.

Utilize high-quality, evidence-based substance use services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical, behavioral health, and ARTS providers.

Provide comprehensive, integrated support to members experiencing substance use and possible co-occurring conditions, including children, adolescents, adults, and justice-involved members.
Engages members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination.
Complete all required assessments, including the Comprehensive Risk Assessment (CHRA).
Coordinates behavioral health, substance use, and medical services, ensuring appropriate provider engagement and adherence to treatment plans.
Improve member’s health literacy while simultaneously addressing health related social needs to positively impact member’s healthcare outcomes and well-being.
Serving as the quarterback of the member’s interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery.
Facilitating ICT meetings, ensuring seamless communication among providers, Service Coordinators, and Care Management Extenders.
Engaging in biannual and quarterly face-to-face visits, ensuring continuous monitoring and proactive intervention.
Must be able to work with autonomy but reach out when support is needed.
Collaborates with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members’ preferences and needs.
Will follow processes, and procedures to ensure compliance with regulatory requirements by the Virginia Department of Medical Assistance Services (DMAS), Center for Medicare and Medicaid Services (CMS) and the National Committee on Quality Assurance (NCQA).

Use your skills to make an impact

Required Qualifications

Virginia licensed RN or LMHP
Must reside in Virginia; This role will be regionally based in one of the Commonwealth’s six regions: Northern/Winchester (NOVA)
Minimum of 1 year of experience working directly with individuals with substance use disorder (SUD)
Case management experience providing care transitions for ASAM levels of care and overall structured care management for members receiving VA Addiction and recovery services
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
Valid driver's license, car insurance, and reliable transportation

Preferred Qualifications

Case Management Certification (CCM)
Experience working with Medicare, Medicaid and dual-eligible populations
Field Case Management Experience
Experience working with pregnant and post-partum population with SUD, including Substance Exposed Infants
Knowledge of community health and social service agencies and additional community resources
Knowledge of ASAM levels of care
Managed Care Experience.
Bilingual preferred (Spanish, Arabic, Vietnamese or other)

Additional Information

Workstyle: This is a remote position that will require you to travel.
Travel: Up to 25% of the time to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as field interactions with staff, providers, members, and their families.
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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Performs therapeutic nursing interventions as established by individualized plan of care for the patient and his/her family. Recognizes potential problems and responds to general information/data indicating urgent and/or emergent risk to the patient. Initiates emergency resuscitative measures as appropriate. Assumes responsibility and accountability for effectively managing the care of a specialty patient population. Provides care in a non-judgmental, non-discriminatory manner that is culturally sensitive to the patient and family, preserving their autonomy, dignity, and rights. Collaborates with interdisciplinary team members to ensure patient care interventions are appropriate. Evaluation Evaluates patient’s responses to care based on effectiveness of nursing interventions/actions in relationship to established goals. Initiates changes in the interdisciplinary care plan based on this evaluation. Problem solves with the specialty team to improve patient outcomes. Documents patient assessment findings, physical/psychosocial responses to nursing intervention and progress towards problem resolution. Patient Education Identifies learning needs of patients/families and teaches by adapting standard information based on needs. Ensures that the patient/family demonstrates knowledge, within the abilities of the patient. Communicates with patients and family to identify their needs and include them in the plan of care. Acknowledges and supports determinations by the patient and/or family concerning treatment. Self and Peer Learning Assumes responsibility for assessing and meeting own learning and professional development needs. Maintains current competency in nursing specialty and requirements for department; attends required educational programs and may attend additional educational workshops; reviews nursing professional publications; establishes personal networks; may participate in professional societies. Seeks additional educational opportunities for clinical development and is either ready to learn the charge nurse role or currently functioning in a charge nurse role. Collaboration Makes sound judgments in the decisions involved in coordinating multiple, increasingly complex patient care demands. Supervises delegated care based on abilities of personnel and patient acuity. Reports changes in patient condition to appropriate personnel. Service Recovery Participates in service recovery and uses appropriate resources during complex situations. Handles conflict resolution in an appropriate, timely and consistent manner. Resource Utilization and Stewardship Supports organizational efforts regarding appropriate resource utilization (i.e. flexing during low census). Able to serve as a preceptor/mentor and works directly with employees to fulfill planned orientation to the department. May assist in the orientation, instruction, direction, and evaluation of students assigned to the unit. Able to be trained for a charge nurse role or is currently functioning in a charge nurse role. Improvement Activities Participates in data collection for quality assurance activities if assigned by department leader. Identifies and communicates recurring practice concerns in specialty areas and their impact on care. Participates in initiatives resulting from nurse-sensitive, quality, and other specialty indicators and/or unit-based quality metrics. Demonstrates the utilization of Centra’s safety behaviors (i.e. Speak Up for Safety). Research/Evidence Based Practice/Quality Improvement Projects May participate in Research or Evidence Based Practice projects. Able to communicate research and quality improvement data/findings to peers. Able to interpret quality improvement data relevant to the clinical specialty and communicate this data to peers. Contributes to development or implementation of methods to improve quality care in areas identified as deficient by quality improvement data studies. Ethics Maintains confidentiality in matters as outlined in Centra policies. Delivers care in a manner that protects patient autonomy, dignity, and rights. Serves as a patient advocate. Maintains patient-nurse relationships with professional role boundaries. Other Duties As Assigned. QUALIFICATIONS Qualifications Education Minimum: Diploma or Associate Degree in Nursing Education Preferred Bachelor of Science – Nursing (BSN) Work Experience Minimum One Year of Nursing (RN) Experience Licenses & Certifications Minimum Registration as a registered nurse in the Commonwealth of Virginia and/or holds a compact license to practice in Virginia. Basic Life Support Additional Specialty Requirements – Advanced Cardiac Life Support Cath Lab/Electrophysiology Operating Room Critical Care (All) Endoscopy PACU Interventional Radiology Birth Center Centra Specialty Hospital Outpatient Ambulatory Surgery Plastic SurgeryRegistered Nurse Outpatient Ambulatory Surgery Additional Specialty Requirements – Pediatric Advanced Life Support Pediatrics Additional Specialty Requirements – Advanced And Pediatric Advanced Life Support Emergency Dept.