RN, Field Care Manager(Maternal-Child Health) - Roanoke/Alleghany, Virginia

Humana; Troutville (VA); Remote; USD 60,000 - 90,000; Full time

Job summary

Join a forward-thinking company dedicated to improving health outcomes for members in Virginia. As a RN Field Care Manager, you will play a crucial role in assessing and guiding high-acuity members, particularly during pregnancy and postpartum periods. This remote position offers the chance to work independently while collaborating with a dedicated team. With a focus on wellness, you will develop personalized care plans and navigate community resources, ensuring members receive the support they need. If you are passionate about making a difference in healthcare and thrive in a dynamic environment, this opportunity is perfect for you.

Qualifications

• 2+ years of healthcare and case management experience required.
• Active RN license in Virginia without disciplinary action.

Responsibilities

• Conduct health risk assessments and develop individualized care plans.
• Collaborate with providers and ensure compliance with regulations.

Skills

Healthcare experience

Case management

Communication skills

Interpersonal skills

Electronic medical records

Microsoft Word

Microsoft Excel

Bilingual skills

Education

Active RN license in Virginia

Bachelor’s of Science in Nursing (BSN)

Tools

Microsoft Outlook

Job description

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 to promote wellness by guiding members and families toward appropriate resources, especially for pregnant and postpartum members. The role involves varied work assignments requiring interpretation and independent decision-making.

1. Conduct health risk assessments across the care continuum.
2. Assess members, develop individualized care plans, and participate in interdisciplinary team meetings.
3. Implement strategies to manage physical, environmental, and psycho-social health issues.
4. Identify and address barriers to effective care.
5. Monitor member progress and evaluate outcomes.
6. Understand departmental, segment, and organizational strategies and objectives.
7. Make work decisions independently, sometimes in ambiguous situations, with minimal guidance.
8. Collaborate with internal and external providers and departments.
9. Ensure compliance with contractual and regulatory requirements.
10. Follow established guidelines and procedures.

Required Qualifications

• Must reside in the central to northern Roanoke/Alleghany Region of Virginia, including Giles, Montgomery, Roanoke, Salem, Bedford, Craig, Botetourt, Covington, Alleghany, Rockbridge, Buena Vista, Lexington, Bath, and Highland.
• Active RN license in Virginia without disciplinary action.
• At least 2 years of healthcare and/or case management experience.
• Minimum 1 year of acute care experience in obstetrics, women’s care, labor and delivery, NICU, or clinical triage.
• Proficient in Microsoft Word, Outlook, and Excel.
• Knowledge of community health and social service agencies.
• Strong communication and interpersonal skills.
• Ability to work independently within scope.
• Experience with electronic medical records and web navigation.
• Willingness to undergo TB screening and travel regionally for face-to-face assessments.
• Valid driver’s license and personal vehicle insurance as per state requirements.

Preferred Qualifications

• Bachelor’s of Science in Nursing (BSN).
• 3-5 years of in-home assessment and care coordination.
• Lactation certification or experience.
• Experience in health promotion, coaching, and wellness.
• Managed care experience.
• Certification in Case Management (CCM).
• Motivational Interviewing certification or knowledge.
• Bilingual skills, especially in Spanish, Arabic, Vietnamese, Amharic, or Urdu.

Additional Information

• This is a remote position requiring travel up to 75% regionally.
• Work hours are Monday-Friday, 8:00 am – 5:00 pm EST.
• Applicants must pass a language proficiency assessment if speaking a language other than English.
• Internet requirements include minimum speeds of 25 Mbps download and 10 Mbps upload.
• Occasional onsite meetings may be required at Humana’s Glen Allen, VA office.
• Use of HireVue for interviews is part of the hiring process.