Field Care Manager

Employment Type: Full-time

Position Overview

Humana Healthy Horizons in Ohio is seeking a Field Care Manager to join our caring community. In this role, you will assess and evaluate member needs and requirements to achieve and maintain optimal wellness. You will guide members and their families toward and facilitate interaction with appropriate resources for their care and wellbeing. This is an opportunity to begin your future with a Fortune 500 Company, taking advantage of competitive pay, lucrative 401k matching programs, and more.

The Field Care Manager Nurse 2 (Care Manager Plus, Physical Health) performs varied work assignments that frequently require interpretation and independent determination of appropriate actions.

Two Separate Roles Defined:

• PH CM: Performs the full scope of care coordination activities for members not assigned to a Care Coordination Entity (e.g., Ohio RISE Plan, CME) or who choose to receive care management from the MCO. Serves as the single point of contact for care coordination.
• PH CM Plus: Ensures the completion of the full scope of care coordination activities for members assigned to a Care Coordination Entity (e.g., Ohio RISE Plan, CPCs, CMEs). Serves as the single point of contact for care coordination.

Responsibilities

• Ensures members receive the full scope of care coordination services, including comprehensive assessment completion (inclusive of HRA), person-centered care plan completion, and identification/addressing of ongoing needs.
• Ensures no duplication of services with CCEs (Ohio RISE Plan, and/or CME).
• Provides actionable data, information, and support to assist the CCE, Ohio RISE Plan, and/or CME in meeting member care needs.
• Integrates information collected by the CCE into its Care Coordination Portal to minimize duplication.
• 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.
• Utilizes a holistic, member-centric approach to engage and motivate members and their families through recovery and health and wellness programs.
• Performs telephonic and face-to-face assessments and evaluations of member needs to achieve and/or maintain an optimal wellness state.
• Guides members/families toward appropriate resources for care and overall wellbeing.
• Ensures member progress towards desired outcomes through continuous monitoring of care via assessments and/or evaluations.
• Performs clinical intervention through the development of a care plan specific to each member based on clinical judgment, changes in health or psychosocial wellness, and identified triggers.
• Collaborates with providers and community services to promote quality and cost-effective outcomes.
• Coordinates delivery of needed services/supports for Physical Health, Social Determinant of Health, and value-added benefits.
• Coordinates across the transdisciplinary care team (at a minimum the PCP) and transitions of care.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Submits incident reports.

Required Qualifications

• Registered Nurse with 2 years of experience in home case/care management.
• Experience working with the adult population.
• Knowledge of community health and social service agencies and additional community resources.
• Ability to travel to member's residence within 30 to 40 miles.
• Exceptional communication and interpersonal skills with the ability to quickly build rapport.
• Ability to work with minimal supervision.

Company Information

Become a part of our caring community and help us put health first. Take advantage of Humana's competitive pay, lucrative 401k matching programs and more! Apply now to begin your future with a Fortune 500 Company!