RN Field Care Manager, Nurse

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Evaluate and assess the needs and requirements of members to help them achieve or maintain optimal wellness.

• Direct members and their families to suitable care and wellbeing resources.

• Oversee the physical, environmental, and psychosocial health requirements of members.

• Manage a caseload and conduct assessments in members' homes, community environments, and via telephone.

• Provide clinical support and direction for members with complex medical needs.

• Create and coordinate care plans to ensure members receive the necessary services.

• Identify and address barriers to care while advocating for the best possible outcomes for members.

• Review, evaluate, and complete medical complexity attestations along with clinical oversight tasks.

• Assess care requirements to guarantee services are provided in the least restrictive environment.

• Develop and adjust Individual Care Plans collaboratively with the interdisciplinary care team.

• Assist members and caregivers in accessing social, housing, educational, and other essential services.

• Act as the primary contact for the Interdisciplinary Care Team.

• Collaborate with members, care team participants, and external resources.

• Conduct in-home visits 75–90% of the time within designated areas of Wayne and/or Macomb Counties.

⛳️ Requirements

• Must be a resident of Michigan, specifically in Wayne or Macomb Counties.

• Hold an active Michigan license as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN), including Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS), without any disciplinary actions.

• Possess over 2 years of experience in healthcare and/or case management.

• Able to travel to homes and community locations for in-person assessments.

• Experience in working with adult populations and managing diseases.

• Familiarity with community health and social service agencies, as well as additional community resources.

• Proficient in using electronic information applications and software programs, including electronic medical records.

• Strong keyboarding and web navigation skills.

• Intermediate to advanced computer proficiency, with experience in Microsoft Word, Outlook, and Excel.

• Possess a valid state driver's license.

• Have personal vehicle liability insurance that meets required limits.

• Must meet home internet requirements of at least 25 Mbps download and 10 Mbps upload.

• Capable of working from a dedicated space without interruptions to safeguard member PHI/HIPAA information.

• BSN is preferred.

• Experience in in-home assessments and care coordination is preferred.

• Background in health promotion, coaching, and wellness is preferred.

• Familiarity with Medicaid Long Term Care is preferred.

• Previous experience in managed care is preferred.

• Bilingual skills in Spanish, Arabic, or Chaldean Neo-Aramaic are preferred.

• Certification in Case Management is preferred.

• Knowledge of or certification in Motivational Interviewing is preferred.

• Must complete TB screening if selected.

🏝️ Benefits

• Competitive pay, with eligibility for an annual performance-based bonus.

• Employee Referral Program.

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Mileage reimbursement for eligible travel.

• Home office work arrangement.

• Occasional travel to Humana offices for training or meetings.