RN, Field Care Manager

Humana

Belle Chasse (LA)

Hybrid

USD 65,000 - 90,000

Full time

4 hours ago
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Benefits offered by this job

Mileage reimbursement

Job summary

Humana is seeking a RN Field Care Manager 2 (Physical Health) to assess and guide members toward appropriate care resources, aiming for optimal wellness. You will perform telephonic and in-person assessments, develop personalized care plans, and coordinate with providers to ensure comprehensive, cost-effective services.

The role emphasizes independent judgment, adherence to regulatory requirements, and collaboration with multidisciplinary teams within Louisiana Medicaid.

Qualifications

  • Active RN license in Louisiana.
  • Two+ years clinical experience with diverse populations.
  • Knowledge of community health resources and agencies.
  • Experience with electronic medical records and narrative documentation.
  • Strong keyboarding and web navigation skills; proficient in MS Word/Outlook/Excel.

Responsibilities

  • Engage and empower members and families to support recovery and wellness.
  • Conduct telephonic and in-person assessments to evaluate needs and direct to resources.
  • Monitor member progress toward individualized care goals.
  • Develop and implement personalized care plans based on clinical judgment.
  • Collaborate with healthcare providers and community services for quality, cost-effective care.
  • Coordinate delivery of essential services addressing physical health and social determinants.
  • Facilitate communication across the care team for seamless transitions.
  • Align daily practices with organizational goals and strategies.
  • Document and submit incident reports per policies.

Skills

RN license
Independent work
Communication
Web navigation

Tools

EMR software
Microsoft Word
Outlook
Excel

Job description

Become a part of our caring community

The RN, Field Care Manager 2 (Physical Health) assesses and evaluates members’ 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. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Become a part of our caring community

The RN, Field Care Manager 2 (Physical Health) assesses and evaluates members’ 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. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

As a RN, Field Care Manager 2 (Physical Health) you will employ a comprehensive, member-focused approach to support individuals in managing physical, environmental, and psycho-social health challenges. You will help identify and address barriers to effective care, ensuring members receive the resources and support necessary for optimal wellbeing. You will report to the Manager of Care Management within the Louisiana Medicaid Team.

  • Engage and empower members and their families by utilizing holistic strategies to support recovery, health maintenance, and participation in wellness programs.
  • Conduct telephonic and in-person assessments to evaluate member needs, guiding them and their families toward appropriate resources to achieve and sustain their best possible health outcomes.
  • Continuously monitor member progress, using regular assessments and evaluations to ensure advancement toward individualized care goals.
  • Develop and implement personalized care plans based on clinical judgment, changes in member health status, psychosocial factors, and identified triggers, providing targeted clinical interventions.
  • Collaborate with healthcare providers, community organizations, and services to facilitate quality, cost-effective care and support for members.
  • Coordinate delivery of essential services, addressing physical health needs, social determinants of health, and additional value-added benefits to comprehensively support members.
  • Facilitate communication and coordination across the interdisciplinary care team, including primary care providers, to ensure seamless transitions of care and integrated service delivery.
  • Demonstrate an understanding of departmental, segment, and organizational strategies and objectives, aligning daily practices with broader operational goals.
  • Document and submit incident reports observing organizational policies and regulatory requirements.
Required Qualifications
Use your skills to make an impact

Candidates must reside within Louisiana Regions 1, 2, 3, 4, or 8, which include the following parishes:

  • Region 1: Jefferson, Orleans, Plaquemines, St. Bernard.
  • Region 2: Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe Coupee, West Baton Rouge, West Feliciana.
  • Region 3: Assumption, Lafourche, St. Charles, St. James, St. John, St. Mary, Terrebonne.
  • Region 4: Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin, Vermillion.
  • Region 8: Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, West Carroll.
Candidates Must Meet All Of The Following Requirements
  • Active, unrestricted Registered Nurse (RN) license in the state of Louisiana.
  • Two (2) or more years of clinical experience working with diverse populations, including youth, adults, and geriatric populations.
  • Knowledge of community health and social service agencies, as well as additional community resources.
  • Experience using a variety of electronic information applications and software programs, including electronic medical records, with excellent keyboarding and web navigation skills and the ability to provide narrative documentation.
  • Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
  • Ability to work independently with minimal supervision, exercise sound judgment within the scope of the role, and proactively adapt care plans to meet changing member needs and circumstances.
Preferred Qualifications
  • Bachelor’s degree in nursing (BSN).
  • Certification in Case Management (CCM).
  • Experience with health promotion, coaching and wellness.
  • Previous care or case management experience.
  • Managed Care Health Plan experience.
  • Bilingual or multilingual (English, Spanish, Creole); with the ability to read, write, and speak in both languages with no limitations or assistance.
Additional Information
  • Workstyle: This position is primarily field-based; however, the designated work location is a remote home office when not conducting community or member visits.
  • Work Schedule: Monday through Friday 8:00 AM to 5:00 PM CT, management may request overtime to meet business needs and require approval.
  • Travel: Up to 50% within the assigned Louisiana region to conduct face-to-face interactions with members, families, and providers based on member tier level. Additional travel may be required for community engagement activities and team meetings throughout Louisiana.
  • Mileage Reimbursement for Travel: Mileage reimbursement is provided for work-related travel. Eligible mileage includes travel from your home to your first work location, travel between client or assignment locations during the workday, and travel from your final work location back
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