Specialty Care Navigator - Substance Use Disorder (SUD)
Spring HealthFull Time
Mid-level (3 to 4 years), Senior (5 to 8 years)
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.
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.
Health insurance provider for seniors and military
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.