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- The Field Care Manager Nurse 2 assesses and evaluates member’s 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.
- This role requires residence in the Western Kentucky Region.
- Must reside within the following Counties: Ballard, Calloway, Carlisle, Fulton, Graves, Hickman, Livingston, Marshall, McCracken, and Trigg
- Collaborate with members of an inter-disciplinary team to meet the needs of the individual and the population
- Identify problems or opportunities that would benefit from care coordination
- Engage the member and complete a health and psychosocial assessment, taking into account the cultural and linguistic needs of each member
- Engage with the member in a variety of settings to establish an effective, professional relationship.
- Settings for engagement include but are not limited to; hospital, provider office, community agency, member s home, telephonic or electronic communication
- Identify and prioritize the individual s care management needs and goals in collaboration with the member and caregivers
- Identify and manage barriers to achievement of care plan goals
- Identify and implement effective interventions based on clinical standards and best practices
- Maximize the client s health, wellness, safety, adaptation, and self-care through effective care coordination and case management
- Educate the member and other stakeholders about treatment options, community resources, insurance benefits, etc.
- so that timely and informed decisions can be made
- Employ ongoing assessment and documentation to evaluate the member s response to the plan of care
- Evaluate client satisfaction through open communication and monitoring of concerns or issues
- Collaborate with facility based case managers and providers to plan for post-discharge care needs or facilitate transition to an appropriate level of care in a timely and cost-effective manner
- Appropriately terminate care coordination services based upon established case closure guidelines
- Provide clinical oversight and direction to unlicensed team members as appropriate
- Document care coordination activities and member response in a timely manner according to standards of practice and policies regarding professional documentation
- Looks for ways to improve the process to make the members experience easier and shares with leadership to make it a standard, repeatable process
- Regular travel to conduct member visits, provider visits and community based visits as needed to ensure effective administration of the program
- Registered Nurse Licensed in the State of Kentucky without restrictions.
- Three to five (3-5) years varied experience in nursing/healthcare fields (discharge planning, case management, care coordination, and/or home/community health experience)
- Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
- Collaborate with team members to optimize outcomes for members
- Strong advocate for members at all levels of care
- Strong understanding and respect of all cultures and demographic diversity
- Proven track record of demonstrating empathy and compassion for individuals
- Exceptional 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
- Combination remote work at home and onsite member field visits
- Must reside in or within a 50 mile radius of the following Western Kentucky counties: Ballard, Calloway, Carlisle, Fulton, Graves, Hickman, Livingston, Marshall, McCracken, and Trigg
- Monday through Friday 8:00 AM to 6:00 PM Eastern Time
- Must be willing to travel 25% to meet with members.
- This role is a part of Humana’s Driver Safety program and therefore requires and individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,00 limits
- Valid driver’s license, car insurance, and access to an automobile
- This role is considered patient facing and is a part of Humana’s Tuberculosis (TB) screening program.
- If selected for this role, you will be required to be screened for TB.
- Work at Home Requirement
- Internet and Home Office
- requirements: Must have the ability to provide a high speed DSL or cable modem for a home office.
- Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
- A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
- Satellite and Wireless Internet service is NOT allowed for this role.
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- Bachelor s of Science in Nursing (BSN) preferred
- Five (5) years or more clinical experience is preferred
- Three (3) years or more Medicaid and/or Medicare managed care experience is preferred
- Certification in Case Management
- Bilingual English and Spanish – Language Proficiency Assessment will be performed to test fluency in reading, writing and speaking in both languages.
- Interview Format *
- As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability.
- We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
- You will be able to respond to the recruiters preferred response method via text, video or voice technologies If you are selected for a screen, you may receive an email correspondence *(please be sure to check your spam or junk folders often to ensure communication isn t missed)
- inviting you to participate.
- You should anticipate this screen to take about 15 to 30 minutes.
- Your recorded screen will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
- Covid Vaccination Processes: *
- Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters.
- Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
- Job Type: Full-time
- RN in the state of Kentucky without restrictions (Preferred)
- Work Location: Remote
- Associated topics: ambulatory, cardiothoracic, care unit, infusion, maternal, neonatal, recovery, surgical, tcu, transitional
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Updated 4 hours ago