Become a part of our caring community and help us put health first
The NICU Care Manager (Field Care Manager, Nurse 2) will complete assessments in person and telephonically with the membership. This position evaluates high acuity member's needs and requirements to achieve and/or maintain optimal wellness. This position will facilitate interaction with resources appropriate for the care and well-being of NICU members. The NICU Care Manager’s work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
- 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. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.
- The NICU Care Manager will review, analyze, assess, and attest for medical complexity.
- Responsible for health risk assessments along the continuum of care for members.
- Candidate will assess the member, create individualized care plans, and attend interdisciplinary care team meetings.
- Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
- Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
- Collaboration with internal and external providers or departments to meet the members needs.
- Meet requirements for contractual and regulatory compliance.
- Responsible for providing clinical oversight and support for care coaches providing specialized Case Management wrap around services and supports, maintaining a case load.
- Follows established guidelines/policies/procedures.
Use your skills to make an impact
Required Qualifications
- Must reside in Virginia; This role will be regionally based in one of the Commonwealth’s six regions: Tidewater, Central, Northern/Winchester, Western/Charlottesville, Roanoke/Alleghany, Southwest. This includes within 40 miles of adjacent states to Virginia.
- Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.
- Minimum 2 years of experience of in-home case/care management.
- Minimum 1 year of acute care experience working in a Neonatal Intensive Care Unit (NICU) to include experience with high/complex acuity.
- Knowledge of community health and social service agencies and additional community resources.
- Ability to travel to region-based facilities and homes for face-to-face assessments.
- Exceptional oral and written 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.
- Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel.
- Excellent keyboard and web navigation skills.
- Ability to work a full-time schedule
- This role is considered member facing and is part of Humana Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
- This role is part of Humana's Driver Safety program and therefore requires an individual to has to have a valid state driver’s license and proof of personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
Preferred Qualifications
- BSN Bachelor’s of Science in Nursing.
- 3+ years of in-home assessment and care coordination experience.
- 3+ years of experience in the Neonatal Intensive Care Unit (NICU) - strongly preferred
- Experience as a lactation consultant and/or IBCLC International Board Certified Lactation Consultant experience with health promotion, coaching and wellness.
- Previous managed care experience.
- Bilingual preferred (Spanish, Arabic, Vietnamese or other).
- Certification in Case Management.
- Motivational Interviewing Certification and/or knowledge.
Additional Information
- Workstyle: Field - This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.
- Travel: 50 - 75% field interactions with members, and their families and providers. May need to attend onsite meetings occasionally in Humana Healthy Horizons office in Glen Allen, VA.
- Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
- Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
WAH Internet Statement
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
