Remote Maternity Care Management Field Nurse, LA

Humana

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Location: LA
Location Type: Remote
Schedule:Full_time
Req: R-322467

Description

 

The Maternity Field Care Management Nurse (Field Care Manager Nurse) assesses and evaluates member’s needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Field Care Manager Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

 

Responsibilities

 

We have a position available in lake Charles, Louisiana

 

Position Responsibilities:

 

The Field Care Manager 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.

 

  • Utilize a holistic, member-centric approach to engage and motivate members and their families through recovery and health and wellness programs.
  • Performs telephonic and face to face assessments and evaluations of the member’s needs to achieve and/or maintain an optimal wellness state by guiding members/families toward the appropriate resources for the care and overall wellbeing of the member.
  • Ensures member is progressing towards desired outcomes by continuously monitoring care through assessments and/or evaluations.
  • Perform clinical intervention through the development of a care plan specific to each member based on clinical judgement, changes in members’ health or psychosocial wellness, and identified triggers
  • Collaborates with providers and community services to promote quality and cost-effective outcomes.
  • Coordinates delivery of needed services/supports for Physical Health, Social Determinant of Health and value added benefits.
  • Provide relevant resources to support families with health and wellness programs
  • Coordinates across the transdisciplinary care team (at a minimum the PCP) and transitions of care
  • Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
  • Submits incident reports
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

               

Required Qualifications

  • Licensed Registered Nurse (RN) in the state of Louisiana without restrictions.
  • Minimum two (2) years of clinical experience in maternity, Labor & Delivery, L&D, mother baby)
  • Intermediate to advanced computer skills and experience with Microsoft Word, Outlook, and Excel
  • Ability to use a variety of electronic information applications/software programs including electronic medical records.
  • Exceptional communication and interpersonal skills with the ability to quickly build rapport.
  • Ability to work with minimal supervision within the role and scope with the ability to adapt care plan to change in member status.

 

Preferred Qualifications

 

  • Case Management Certification (CCM) or willingness to obtain within two (2) years of employment.
  • Understanding of the current state Maternal/Child Mortality Morbidity
  • Basic Breastfeeding knowledge
  • Experience working with Medicare, Medicaid and dual-eligible populations.
  • Field Case Management Experience
  • Health Plan experience
  • Knowledge of community health and social service agencies and additional community resources
  • Experience with health promotion, coaching and wellness

 

Work-At-Home Requirements

 

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if approved by leadership
  • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office associates 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

Workstyle: Combination remote work at home and onsite/home member visits

Hours: Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs and requires approval.

Travel: Must be willing to travel for field visits to meet with members in your Region, based on member tier level (to be explained during the interview) Coverage area by position: Region 5 – Lake Charles and surrounding area

Driver’s License, Transportation, Insurance This role is a part of Humana’s Driver Safety program and therefore requires and individual to have

a valid state driver’s license proof of personal vehicle liability insurance with at least 100,000/300,000/100,00 limits, and access to a reliable vehicle

Tuberculosis (TB) screening program

This role is considered patient facing and is part of Humana At Home’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

 

Additional Information

 

Interview Format

 

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor.  This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. (please be sure to check your spam or junk folders often to ensure communication isn’t missed) If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

 

 

Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH’s Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)

 

#LI-KK1

Limited Geography Remote – This is a remote position but located within a specific geography. #LI-Remote

 

Scheduled Weekly Hours

 

40