rn care manager

NorthLakes Community Clinic

<div><h1 class="jobSectionHeader">Caring for our community starts with you. Join a team that believes everyone deserves care.</h1>
Candidates must reside within NorthLakes' service area at the time of hire and maintain residency throughout employment.
To engage teams and patients in the delivery of evidence-based, patient-centered, lifelong care. 
 
Salary begins at $29.95 + per hour depending on experience.
The RN Care Manager will manage high risk and chronic illness to promote whole-person, integrated, quality care. The RN Care Manager will employ a person-centered and team approach, partnering with patients and their family/caregiver(s), clinic/hospital/providers and specialty providers and other staff, and community resources.<ul><li>
Conduct in-office patient visits as outlined in care plan and based on patient&rsquo;s health status and self-management interests</li><li>
Create and promote engagement with a care plan, developed with the patient, primary care provider and/or specialty care provider and family/caregiver(s)</li><li>
Support the delivery of integrated, whole-person care in family medicine, recovery and psychiatric care.</li><li>
Engage patients in self-management and shared decision-making</li><li>
Increase utilization of preventative care services</li><li>
Promote timely access to appropriate care to reduce emergency room utilization and hospital readmissions</li><li>
Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals</li><li>
Work with internal providers on coordinating schedules, getting a client in to other service lines as needed</li><li>
Facilitate patient access to appropriate medical and specialty providers, assisting with residential and detox referrals</li><li>
Assist with the identification of &ldquo;high-risk&rdquo; patients with a chronic illness and those with special health care needs, coordinate care, and track outcomes</li><li>
Assess for social drivers of health and work with Community Health Workers on integrated Care Management</li><li>
Attend all Care Management training courses/webinars and meetings &ndash; contribute to the development of the Care Management Program</li><li>
Participate in quality improvement efforts by; utilizing dashboards, tracking tools and providing quality reporting data monthly</li><li>
Follow protocols, clinical policy and procedure in collaboration with the Primary Care Provider/Specialty Care provider for chronic care management. Follows clinical guidelines protocols and policies related to all direct patient care.</li><li>
Performs in-clinic triage and medication refills</li><li>
Work with Triage Nurse team as needed to perform medication refills and triage.</li><li>
Conducts nursing assessments according to assessment tools to determine services and service level of care needed.</li><li>
Under provider direction performs and/or assists provider in inductions utilizing COWS, administers patient injections and provides education on naloxone.</li><li>
Helps monitor OB clients, talking with their OB provider about pain management for delivery and postpartum.</li><li>
Provides education about Neonatal Abstinence syndrome, support systems, and concerns</li><li>
General Education with patients about substance use, tobacco cessation, prevention, communicable disease management, new medical diagnosis</li><li>
Monitor medication adherence, including checking the PDMP, help monitor side effects, provide patient education, assist prior authorizations and prescription assistance programs</li><li>
Provide medication reconciliation and complete refill requests, including for controlled substances under direction and approval from prescribing provider</li><li>
Connect patients to relevant community resources, with the goal of enhancing patient health and well-being, increasing patient satisfaction, and reducing health care cost
</li><li>Serve as the contact point, advocate, and informational resource for patients, care team, family/caregiver(s), payers, and community resources</li><li>
Facilitate and attend meetings between patient, family/caregiver(s), care team, and community resources, as needed</li></ul><div>
Qualifications and Education Requirements</div><div><ul><li>
Minimum Level of Completed Education: Associates Degree in Nursing</li><li>
Prior years of experience in similar role: RN with two+ years related experience and/or training</li><li>
Experience with systems, computer applications/software: Electronic Health Records, preferably Epic.</li><li>
Required (or Preferred) Licensure/Cert/Credentials: Current, valid and unrestricted WI license to practice as a Registered Nurse. Current CPR certification required.</li><li>
Evidence of leadership, communication, education and counseling skills. Local knowledge about community health care and social welfare resources preferred.</li></ul>
Benefit Statement
For full time and part time employees who work 24 or more hours per week we offer a generous benefits package that includes:<ul><li>Medical and dental insurance</li><li>Employer paid group term life and disability</li><li>Employer contribution toward Health Savings Account</li><li>Flexible Spending Accounts</li><li>Paid Time Off (PTO), Paid Holidays and Paid Leave Bank</li><li>403(b) with a 4% employer match</li></ul>
Various voluntary benefits:<ul><li>Vision Insurance</li><li>Supplemental Life, AD&amp;D and Disability</li><li>Tuition reimbursement</li><li>Health and Wellness reimbursement program</li><li>Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members</li><li>Partner of HRSA/NHSC loan repayment program</li></ul>
Our Mission is to respond to the healthcare needs of our communities with an integrated array of quality services and actively remove barriers to wellness.
NorthLakes Community Clinic is an Equal Opportunity Employer. All qualified applicants will be considered for employment regardless of age, race, color, creed, religion, sex, sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
All offers of employment are contingent upon successful completion of a criminal background check and references.</div>
At NorthLakes Community Clinic, our organizational competencies highlight the behaviors and values that guide how we work and provide a shared foundation for performance, development, and growth throughout an employee&rsquo;s career with us.
NorthLakes Community Clinic Organizational Competencies
Mission Driven - Advances the organizational mission, vision and values in executing job duties.
Customer Service - Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met.
Quality - Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
Creativity - Generates new ideas, supports change, provides innovative solutions, solves problems creatively.
Integrity - Earns the trust and confidence of coworkers and customers through honest communication, ethical behavior and professionalism in all interactions.
Teamwork - Contributes to meeting team deadlines and responsibilities, listens to others and values opinions, helps team to meet goals, welcomes newcomers and promotes a cooperative team atmosphere.
Self-Development - Seeks out and accepts feedback, is a proactive learner, takes on tough assignments to improve skills, keeps knowledge and skills up-to-date, turns mistakes into learning opportunities.
Job Knowledge - Understands duties and responsibilities, possesses necessary job knowledge and technical skills, maintains job knowledge current.
Communication - Understand and communicate effectively with others using a variety of contexts and formats, which include writing, speaking, reading, listening and interpersonal skills.
Dependability - Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements.
Trauma/Resilience Informed - Understands that trauma is prevalent and resilience can be cultivated and improved; and operates in a manner consistent with these principles.</div>

RN Care Manager

Bayhealth

<div><div>If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
 </div><div>Bayhealth Medical Center is Central and Southern Delaware&rsquo;s healthcare leader with hospitals in Dover and Milford, a s well as stand -alone Emergency Department in Smyrna and a hybrid E mergency Department and Urgent Care in Milton . We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore . Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
</div><div>Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
</div><div><ul><li>Generous Paid Time Off and Paid Holidays
</li><li>Matching 401(k)/403(b) Plans
</li><li>Excellent Health, Dental, and Vision
</li><li>Disability and Life Insurance options
</li><li>On Site Child Care
</li><li>Educational Reimbursement
</li><li>Health Care and Dependent Care Flex Spending Accounts
</li><li>Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
</li></ul></div>Location: Sussex Campus Hospital, Milford Delaware
Status: Full Time 80 Hours
Shift: Days
SALARY RANGE: 37.98 - 58.87HOURLY 
 
General Summary:
An RN who coordinates care and services of selected patient populations across the continuum of illness promoting effective utilization and monitoring of health care resources. Performs concurrent and retrospective patient reviews based on accepted quality, utilization, clinical risk and infection control criteria and communicates effectively with all members of the health care team regarding issues identified. 
 
Responsibilities:
1. Applies utilization management criteria for the review process, distinguishing levels of care and interacting with Physicians, other healthcare team member, and outside agencies.
 
2. Conducts patient screening for assessment of discharge planning interventions. Conducts simple discharges which include home health care, durable medical equipment, and authorizations pharmaceuticals. Provides communication to the Social Worker for complex discharge needs.
 
3. On a concurrent basis, assesses the appropriateness of the level of care; diagnostic testing and clinical procedures; performance and clinical risk issues; and documentation of medical record completeness and reports all variances and events.
 
4. Accurately and completely records all required clinical data in the data base to include information for reconsideration letters for denial of days and/or service.
 
5. Demonstrates ability to perform the Medicare denial process.
 
6. Recognizes urgent utilization issues and reports them to the Care Management manager, unit management, and attending physician immediately
 
7. All other duties as assigned within the scope and range of job responsibilities
 
8. ED Care Managers ONLY: Through an interdisciplinary team of health care providers, the care manager in collaboration with the physician will assist in coordinating a comprehensive plan of care using a concurrent integrated review process to determine medical necessity for appropriateness of admission. If admission is not appropriate then assist in a collaborative effort with the patient and significant other to enhance quality of care and focus on appropriateness of outpatient resource use.
 
9. Responsible, in coordination with the physician in developing and reviewing the individualized care plan, therefore assisting with the implementation of the plan of care. Communicate the plan of care with the entire health care team members. Facilitates the efficient delivery of care.
 
10. Assists the physicians with documentation compliance according to Medicare, Medicaid and Commercial payer regulations and guidelines.
 
11. Demonstrates ability to combine medical staff practice patterns, disease trajectory, community resource knowledge, and patient family desires into the critical thinking of discharge planning. Acts collaboratively with the emergency room navigator to coordinate discharge plans and arrangements for patient / families by ensuring a smooth transition from an emergency room level of care to another as required.
 
12. Conducts the initial assessment for the identification of potential discharge needs and provides communication to the Social Service Inpatient Discharge Planners.
 
13. Non-ED ONLY: Performs concurrent denial recovery of all denied days and records outcomes in the clinical data base. Requests sub-acute level of care when applicable to denied days.
 
14. Acts collaboratively with Social Services for post-hospital care needs 
 
 
Required Education, Credential(s) and Experience:
<ul><li>Education: Bachelor Degree
 
; Nursing
 
;
 
</li><li>Credential(s): Registered Nurse
 
Basic Life Support
 
; 
 
 
</li><li>Experience: Required: 5 years nursing experience within the last 10 years Preferred: Utilization Review, Care/Case Management experience
</li></ul>Preferred Education, Credential(s) and Experience:
<ul><li>Education:
</li><li>Credential(s): Certified Case Manager
 
Certified Professional in Utilization Review 
 
 
 
</li><li>Experience:
</li></ul>To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/</div>

Arosa

<div>RN Care Manager
Dynamic experienced Aging Life Care Professional
In this role, you'll be pivotal in expanding our company and supporting our clients. Key responsibilities of the position include extensive community outreach as well as providing clinical leadership. The ideal candidate should have strong relationships with local healthcare professionals and referral sources. The expectation is that this teammate will reach out to these individuals and help us grow our patient census. Additionally, you'll also handle various clinical duties such as initial assessments, weekly care management, coordinating with the Interdisciplinary Team (IDT), and overseeing our caregiving team.
The RN Care Manager will:<ul><li>
Provide oversight to all in-home caregivers</li><li>
Perform routine in-home supervisory visits per State Regulations</li><li>
Mentor and guide caregivers within their assigned region</li><li>
Provide education to caregivers, staff, clients, and other parties as needed, on clinical issues ranging from disease process to how to appropriately perform hands-on tasks</li><li>
In-Home Nursing</li><li>
The second part of this hybrid position requires the RN Care Manager to be comfortable and confident in providing some in-home, hands-on nursing tasks.
</li></ul>Tasks may include:<ul><li>
Wound Care</li><li>
Medication Administration</li><li>
Medication Box Set up and refill visits</li><li>
Catheterizations</li><li>
PIV/PICC dressing changes</li><li>
Blood draws</li></ul>
Other Duties (include but not limited to)<ul><li>
Intake Assessments and Consultations</li><li>
Performance Management</li><li>
Community Outreach/Support</li><li>
Care Management Services</li></ul>
Knowledge and Skill Requirements:<ul><li>
Educational Minimum Requirement: an Associate Degree in Nursing; Preferred candidate: Bachelor&rsquo;s or Master&rsquo;s Degree in Nursing.</li><li>
Must be a Registered Nurse (RN) in the state for which they are applying for the position.</li><li>
A minimum of two (2) years&rsquo; experience in geriatrics, home care, home health, and/or care management required; other professional experience may substitute.</li><li>
Ability to work in a team environment
</li><li>Ability to interface effectively and professionally with client committees, including family, physicians, attorneys, etc.
</li><li>Excellent written and verbal communication skills required.
</li><li>PC literacy required.
</li><li>Valid driver&rsquo;s license and proof of current auto insurance required.
</li></ul>Arosa is a best-in-class national provider of in-home care and care management services. With offices in California, Florida, Illinois, Nevada, New Jersey, North Carolina, Massachusetts, Tennessee, Texas, Georgia, and Utah the company is creating new standards of care in the fast-growing, in-home care industry, while maintaining a focus on professionalizing direct care jobs and celebrating the meaningful work of caregivers.
At Arosa, we believe that the highest quality in-home care can only be delivered by professionals who feel cared for themselves. We are dedicated in our efforts to attract, train, retain, and treasure the best care professionals. 
Our team-based approach allows us to not only treasure and support our teammates but to also offer our clients tailored, integrated support. We know that the integration of care management and home care leads to higher satisfaction for individuals and their families. Our senior care services combine the expertise of professional Care Managers with the compassion of dedicated Caregivers to deliver better experiences for seniors and their families. 
Every day, we are working to honor our mission to create superior models of care and better quality jobs for our care teammates. We are bold in our efforts as we find new ways to improve the experiences of our clients, our clients&rsquo; families, and our care professionals.
Pay:<ul><li>
Bonus pay</li></ul>
Benefits:<ul><li>
Paid time off</li><li>
Health insurance</li><li>
Dental insurance</li><li>
Vision insurance</li><li>
Life insurance</li><li>
Disability insurance</li><li>
401(k) matching</li><li>
Paid training</li><li>
Mileage reimbursement</li></ul>
Job Type: parttime
Schedule:<ul><li>
Monday to Friday</li></ul>
Education: Associate's degree
Work location: On-site</div>

Part-Time Hourly RN Care Manager

Adventist Health

<div>Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
 
 
Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Plays a critical role in ensuring that patients receive high-quality care while efficiently utilizing medical resources. Reviews patient medical records, assessing the appropriateness and necessity of proposed treatments, and collaborating with healthcare providers and insurance companies to ensure a seamless care experience and the practicing of financial stewardship and denial prevention. Focuses on maximizing patient outcomes and optimizing resource allocation. Utilizes exceptional clinical knowledge, excellent communication skills, and the ability to thrive in a fast-paced and ever-changing healthcare environment.
Job Requirements:
<div>Education and Work Experience:
<ul><li>Associate's Degree in nursing or equivalent combination of education/related experience: Required
</li><li>Bachelor's Degree in Nursing (BSN): Preferred
</li><li>Five years' acute hospital experience required with preferred experience in critical care areas: Required
</li><li>Two years' utilization review experience using the Optum/Inter Qual product within the last 12 months: Required
</li></ul></div><div>Licenses/Certifications:
<ul><li>Registered Nurse (RN) licensure in the state of practice: Required
</li></ul></div><div>Essential Functions:
<ul><li>Completes clinical reviews of acute medical patients using the Optum/Inter Qual tool to determine if the patient is in the right acute setting, receiving the right acute services, during the appropriate length of stay.
</li><li>Participates in annual Optum/Inter Qual training required. Takes the required annual Optum/Inter Qual Interrater Reliability (IRR) test with a minimum passing score as defined in the yearly departmental goals.
</li><li>Meets weekly productivity metrics within 90 days of completing orientation and maintains on a weekly basis as defined in the yearly departmental goals. Meets quality audit metrics within 90 days of completing orientation and maintained on the audit cadence set within the department as defined in the yearly departmental goals.
</li><li>Completes all required departmental education assigned with timeliness and accuracy. Follows all departmental workflows in communication variances to the on-site care management teams when appropriate. Reviews and analyzes medical records to assess the necessity and appropriateness of treatments and interventions.
</li><li>Collaborates with healthcare professionals to develop and implement comprehensive patient care plans. Facilitates communication between the patient, healthcare team, insurance providers, and other stakeholders to ensure a coordinated and efficient care process. Stays up to date with the latest healthcare regulations, insurance guidelines, and evidence-based practices to ensure the delivery of optimal healthcare services.
</li><li>Performs other job-related duties as assigned.
</li></ul></div><div>Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
 
 
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.</div></div>

RN, Care Manager, Utilization Management

<div>Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
 
 
Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Location Details:
<ul><li>Remote position but must live near Glendale, CA, Roseville, CA or Portland, OR
</li></ul>Job Summary:
Plays a critical role in ensuring that patients receive high-quality care while efficiently utilizing medical resources. Reviews patient medical records, assessing the appropriateness and necessity of proposed treatments, and collaborating with healthcare providers and insurance companies to ensure a seamless care experience and the practicing of financial stewardship and denial prevention. Focuses on maximizing patient outcomes and optimizing resource allocation. Utilizes exceptional clinical knowledge, excellent communication skills, and the ability to thrive in a fast-paced and ever-changing healthcare environment.
Job Requirements:
<div>Education and Work Experience:
<ul><li>Associate's Degree in nursing or equivalent combination of education/related experience: Required
</li><li>Bachelor's Degree in Nursing (BSN): Preferred
</li><li>Five years' acute hospital experience required with preferred experience in critical care areas: Required
</li><li>Two years' utilization review experience using the Optum/Inter Qual product within the last 12 months: Required
</li></ul></div><div>Licenses/Certifications:
<ul><li>Registered Nurse (RN) licensure in the state of practice: Required
</li></ul></div><div>Essential Functions:
<ul><li>Completes clinical reviews of acute medical patients using the Optum/Inter Qual tool to determine if the patient is in the right acute setting, receiving the right acute services, during the appropriate length of stay.
</li><li>Participates in annual Optum/Inter Qual training required. Takes the required annual Optum/Inter Qual Interrater Reliability (IRR) test with a minimum passing score as defined in the yearly departmental goals.
</li><li>Meets weekly productivity metrics within 90 days of completing orientation and maintains on a weekly basis as defined in the yearly departmental goals. Meets quality audit metrics within 90 days of completing orientation and maintained on the audit cadence set within the department as defined in the yearly departmental goals.
</li><li>Completes all required departmental education assigned with timeliness and accuracy. Follows all departmental workflows in communication variances to the on-site care management teams when appropriate. Reviews and analyzes medical records to assess the necessity and appropriateness of treatments and interventions.
</li><li>Collaborates with healthcare professionals to develop and implement comprehensive patient care plans. Facilitates communication between the patient, healthcare team, insurance providers, and other stakeholders to ensure a coordinated and efficient care process. Stays up to date with the latest healthcare regulations, insurance guidelines, and evidence-based practices to ensure the delivery of optimal healthcare services.
</li><li>Performs other job-related duties as assigned.
</li></ul></div><div>Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
 
 
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.</div></div>

RN, Care Manager, Utilization Management (Full-Time, Remote)

<div>Our home health and hospice agencies are located throughout California, Hawaii, Oregon and Washington. They serve the entire community and offer personalized in-home care, and many have been recipients of Home Care Elite awards.
 
 
So whether you're looking for the buzz of a large city, the tranquility of nearby mountain bike trails or something in between, we encourage you to explore our organization.
Job Summary:
Plans, organizes and directs home care services to meet the needs of patients in their homes. Manages a patient caseload in an effective and efficient manner. Provides patient care independently, but also collaborates with other core disciplines in accordance with the patient's plan or care to meet care goals. Functions as a resource to patients, family members, and other care team members.
Job Requirements:
<div>Education and Work Experience:
<ul><li>Bachelor's Degree in Nursing (BSN): Preferred
</li><li>Acute care facility or home care experience: Preferred
</li></ul></div><div>Licenses/Certifications:
<ul><li>Registered Nurse (RN) licensure in the state of practice: Required
</li><li>Cardiopulmonary Resuscitation (CPR) or Basic Life Support (BLS OR HS-BLS OR RQIBLS) certification: Required
</li><li>Valid Driver's License (DL) and must be at least 21 years of age or older: Required
</li><li>Current automobile insurance and a reliable automobile: Required
</li><li>Basic Life Support (BLS OR HS-BLS OR RQI BLS) certification: Required
</li></ul></div><div>Essential Functions:
<ul><li>Completes initial and ongoing comprehensive assessments of the patient's needs at appropriate time points as assigned. Completes the nursing assessment of assigned patients. Demonstrates ability to discuss and/or teach pertinent aspects of nursing care and patient rights and responsibilities. Identifies and reports problems, abnormal findings, or nursing diagnoses that need follow up.
</li><li>Implements plan of care in accordance with identified needs. Participates with the patient in clarifying mutually agreed upon goals and incorporates these goals into the plan of care. Provides direct and/or indirect skilled, safe, quality care. Coordinates patient care with other disciplines and integrates input from disciplines. Performs ongoing nursing assessments and changes plans of care as needed.
</li><li>Accurately completes and legibly documents all pertinent information in accordance with established policies and procedures by documenting patient care delivery, patient status, patient's response to treatment, and therapeutic interventions. Ensures that all documentation is completed and submitted in a timely manner. Updates nursing plans and medication profiles when changes occur.
</li><li>Counsels and educates the patient and family in meeting healthcare/nursing and related needs. Provides learning opportunities for patient and caregiver, including written material as appropriate. Initiates appropriate preventative and rehabilitative nursing procedures.
</li><li>Complies with all applicable legal requirements, standards, policies and procedures including, but not limited to the code of conduct, HIPAA, and documentation standards. Demonstrates professional conduct, service excellence and commitment to the mission and values of Adventist Health. On call duties will be assigned based on location and agency operational needs. If assigned by agency leadership, incumbent is required to perform on call duties.
</li><li>Performs other job-related duties as assigned.
</li></ul></div><div>Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
 
 
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.</div></div>

Field RN, Care Manager, Hospice, Hanford area

Humana

<div><h1 class="jobSectionHeader">Become a part of our caring community and help us put health first 
</h1>
The Field Care Manager Nurse 2 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.
How we value you!<ul><li>
Competitive Pay, including eligibility for annual performance-based bonus</li><li>
Employee Referral Program</li></ul>
The Field Care Manager Nurse employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psychosocial health needs.<ul><li>
Must reside in Michigan with the ability to drive to Wayne and/or Macomb Counties.</li><li>
This position is based out of a home office and requires traveling 75&ndash;90% of the time within an assigned area in Wayne and/or Macomb County to conduct in‑home visits with Medicare/Medicaid members.</li></ul>
Position Responsibilities:<ul><li>
The RN Field Care Manager will be responsible for managing a caseload and completing assessments with members in their home or community‑based setting, as well as telephonically.</li><li>
Provides clinical support and guidance, particularly for members with medical complexity. Helps develop and coordinate care plans, ensuring that members receive appropriate services to manage their health needs effectively. Addresses barriers to care and advocates for optimal member outcomes.</li><li>
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities.</li><li>
Ensures members receive services in the least restrictive setting to achieve and/or maintain optimal well‑being by assessing their care needs.</li><li>
Develops and modifies the Individual Care Plan and involves applicable members of the care team (informal caregiver, coach, PCP, etc.) in the care‑planning process.</li><li>
Focuses on supporting members and/or caregivers using an interdisciplinary approach to access social, housing, educational, and other services&mdash;regardless of funding source&mdash;to meet identified needs.</li><li>
Serves as the primary point of contact for the Interdisciplinary Care Team (ICT) and is responsible for coordinating with the member, ICT participants, and external resources to ensure the member&rsquo;s needs are met.</li></ul><h1 class="jobSectionHeader"> 

Use your skills to make an impact 

</h1>Required Qualifications<ul><li>
Must reside in the state of Michigan (Wayne or Macomb Counties)</li><li>
Active Michigan license as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN), including Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS), with no disciplinary action</li><li>
2+ years' experience in Health Care and/or Case Management</li><li>
Ability to travel to homes and community settings for face-to-face assessments</li><li>
Experience working with the adult population, disease management.</li><li>
Knowledge of community health and social service agencies and additional community resources</li><li>
Ability to use a variety of electronic information applications &amp; software programs including electronic medical records</li><li>
Excellent keyboard and web navigation skills</li><li>
Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel</li></ul>
Preferred Qualifications<ul><li>
BSN</li><li>
Experience with in home assessment and care coordination experience</li><li>
Experience with health promotion, coaching and wellness</li><li>
Experience with Medicaid Long Term Care</li><li>
Previous managed care experience</li><li>
Bilingual- Spanish, Arabic or Chaldean Neo-Aramaic</li><li>
Certification in Case Management</li><li>
Motivational Interviewing Certification and/or knowledge</li></ul>
Additional Information<ul><li>Schedule/Time Zone: Monday through Friday, 8:30 AM &ndash; 5:00 PM Eastern Time Zone</li><li>Work Location: Michigan (Wayne and Macomb Counties)</li><li>Work Style: Field</li><li>Travel Requirements: 75%- 90% travel within Wayne and/or Macomb Counties, MI)
</li></ul>Work-at-Home (WAH) Internet Statement: To ensure Home or Hybrid Home/Office employees&rsquo; ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:<ul><li>
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.</li><li>
Satellite, cellular and microwave connection can be used only if approved by leadership.</li><li>
Employees 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.</li><li>
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.</li><li>
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.</li></ul>
TB Statement: This role is considered patient facing and is part of Humana&rsquo;s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Driving Statement: This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain 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.
Eligible mileage includes:<ul><li>
Travel from your home to your first work location of the day.</li><li>
Travel between client or assignment locations during the workday.</li><li>
Travel from your final work location back to your home.</li></ul>
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.
Language Assessment Statement: Any Humana employee 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.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
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, &ldquo;Humana&rdquo;) 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.<h1 class="jobSectionHeader"> 
About us 
</h1>
Humana Inc. (NYSE: HUM) is committed to putting health first &ndash; 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 &ndash; 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.</div>

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