Humana

Field Care Manager Nurse ARTS

Virginia, United States

Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Managed Care, Behavioral HealthIndustries

Requirements

Candidates must be a Virginia licensed RN with at least 1 year of experience working directly with individuals with substance use disorder (SUD). Case management experience providing care transitions for ASAM levels of care and structured care management for members receiving VA Addiction and recovery services is required. The role necessitates residency in Virginia, specifically in the Tidewater region, with the ability to travel for face-to-face assessments. Exceptional communication and interpersonal skills, the ability to work with minimal supervision, intermediate to advanced computer skills including Microsoft Office Suite, and a valid driver's license with reliable transportation are also essential.

Responsibilities

The Field Care Manager Nurse will perform face-to-face and telephonic assessments with members with substance use disorders (SUD), serving as the primary point of contact to provide integrated care. Responsibilities include managing member health issues, identifying and resolving care barriers, enhancing behavioral health outcomes, increasing resiliency and recovery, reducing care gaps, and supporting Virginia’s Medicaid population with integrated substance use care management. This involves utilizing evidence-based services through care coordination, crisis intervention, peer support, and collaboration with medical and behavioral health providers. The role also includes coordinating behavioral health, substance use, and medical services, improving member health literacy, addressing social needs, and serving as the lead for the member’s interdisciplinary care team. Facilitating ICT meetings, conducting biannual and quarterly face-to-face visits, and ensuring compliance with regulatory requirements are also key duties.

Skills

Field Care Management
Substance Use Disorders (SUD)
Integrated Care
Care Coordination
Crisis Intervention
Peer Support
Behavioral Health
Medical Services Coordination
Health Literacy
Health Related Social Needs
Interdisciplinary Care Team (ICT) Facilitation
Risk Assessment
Treatment Plan Adherence
Person-Centered Approach
Community Engagement

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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