Maternal - child Health RN Field Care Manager - Remote Eligible

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). This role involves assessing and evaluating high acuity member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitating interaction with resources appropriate for the care and well-being of members who are pregnant and postpartum.

Role Overview

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.

• 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.

Required Qualifications

• Must reside in the Northern/Winchester Region in the Commonwealth of Virginia and travel to see members in region-based facilities and homes for face-to-face assessments and interactions with members and/or families. In the counties/independent cities of Winchester, Frederick, Clarke, Warren, Shenandoah, Page, Rappahannock, Culpeper, Fauquier, Prince William, Fairfax, Fairfax City, Alexandria, Arlington, Falls Church, Loudoun, Manassas and Manassas Park.
• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
• 2 years of prior experience in health care and/or case management.
• 1 year of acute care experience working in obstetrics, women’s care, labor and delivery, mother, baby, NICU and/or clinical triage.
• Knowledge of community health and social service agencies and additional community resources.
• Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel with the ability to use a variety of electronic information applications/software programs including electronic medical records. Excellent keyboard and web navigation skills.
• 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 travel to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.

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.

Work At Home Requirements

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 required.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• 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.

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.

Workdays and Hours: 40 hours a week - Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).

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. 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.

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.

Screening: 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.

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.

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