Humana

Field Care Manager - RN

Illinois, United States

Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, HealthcareIndustries

Requirements

Candidates must reside in Illinois, preferably in Peoria, Pekin, Macomb, Galesburg, or Springfield. A Registered Nurse (RN) license in Illinois without disciplinary action is required, along with at least 2 years of experience in home-based case/care management and clinical nursing experience (hospital, acute care, or home health). The role demands the ability to travel 75-90% within Illinois, knowledge of community health and social service agencies, exceptional communication and interpersonal skills, and the ability to work with minimal supervision. Proficiency in electronic health records and intermediate to advanced computer skills with Microsoft Word, Outlook, and Excel are necessary. A valid state driver's license and proof of personal vehicle liability insurance with specific limits are also mandatory. Preferred qualifications include a BSN, experience with Medicare/Medicaid members, health promotion/coaching/wellness experience, previous managed care experience, bilingual English/Spanish skills, Case Management certification, and Motivational Interviewing certification or knowledge.

Responsibilities

The Field Care Manager Registered Nurse will assess and evaluate member needs to achieve optimal wellness, guiding them toward appropriate resources. Responsibilities include identifying and resolving barriers to effective care, monitoring patient progress through assessments, creating plans of care, and communicating with internal and external stakeholders. The role involves understanding department and organizational strategy, making independent decisions regarding work methods with minimal direction, and following established guidelines. Field visits to Medicaid members in their homes, supportive living facilities, long-term care facilities, and other care settings will constitute 75-90% of the job. The position is patient-facing and requires participation in Humana's Tuberculosis (TB) screening program and Driver Safety program.

Skills

Registered Nurse (RN)
Case Management
Care Management
Clinical Nursing
Home Health
Community Health
Social Service Agencies
Communication
Assessment
Care Planning

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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