RN Care/Case Manager
RN Care/Case Manager
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$ 71100 - 97800
1 Vacancy
Job Description
Become a part of our caring community and help us put health first
Working within an interdisciplinary care team the Care Navigator is responsible for proactively engaging patients identified as high-risk and implementing targeted interventions to address social needs and increase access to care. The Care Navigator will provide guidance and oversight of care coordination efforts to other members of the team and handle clinical escalations as indicated.
This role requires an understanding of how socio-economic stressors can impact ability to engage in healthcare and subsequent health outcomes. Experience will ideally include prior work with patients with behavioral health diagnoses as well as in navigating local community-based resources and benefit applications.
This role has a mobile presence involving travel to patients homes treatment facilities and community-based settings and assigned clinics to facilitate and foster connections.
Major Duties and Responsibilities
- Conduct Transitions of Care Management for a subset of the patient population including ER and hospital follow ups
- Provide triage guidance and supportive consultation to other team members handling escalated complex cases
- Develop care plans leveraging 5Ms Geriatric best practice framework
- Develop a wholistic view of patient needs related to Social Determinants of Health
- Identify existing barriers to engagement with necessary resources and supports
- Provide education around maintenance of chronic health conditions as well as available options for behavioral care and social support
- Serve as liaison between the patient and the direct care providers assisting in navigating both internal and external systems
- Initiate care planning and subsequent action steps for high-risk members coordinating with interdisciplinary team
- Supporting patients self-determination motivate patients to meet the health goals they have identified
- Refer patient to necessary services and supports
- This field may include but is not limited to: assistance with transportation food insecurity navigation of and application for benefits including Medicaid HCBS working to reduce costs associated with prescription medications organizing schedules of follow up appointments alleviating social isolation
- Lead Interdisciplinary Team Meetings when indicated
- Assess patients family system and conduct family meetings with patient and family when needed
- Participate in creation and facilitation of team training content
- Conduct group psychoeducation and support groups within the Center
- Perform all other duties and responsibilities as required
- Participate in and lead interdisciplinary review of and coordination around complex patients
- Maintain patient confidentiality in accordance with HIPAA
- Document patient encounters in medical record system in a timely manner
- Follow general policies related to fire safety infection control and attendance
Use your skills to make an impact
Required Qualifications
- Registered Nurse (RN license)
- Minimum of 4 years of experience working in healthcare services and navigating community-based resources
Preferred Qualifications
- Familiarity with state Medicaid guidelines and application processes preferred
- Experience working with patients with behavioral health conditions and substance use disorders preferred
- Prior experience conducting home visits and knowledge of field safety practices preferred
- Experience working in care/case management
- 1 years experience in behavioral health
- Prior value-based care experience and working with complex Senior populations
- Experience working effectively within interdisciplinary teams
- Bilingual in English and Spanish with the ability to speak read and write in both languages without limitations or assistance
Skills/Abilities/Competencies Required
- Advanced clinical acumen
- Ability to multi-task in a fast-paced work environment
- Flexibility to fluidly transition and adjust in an evolving role
- Excellent organizational skills
- Advanced oral and written communication skills
- Strong interpersonal and relationship building skills
- Compassion and desire to advocate for patient needs
- Critical thinking and problem-solving capabilities
Working Conditions
This role has a mobile presence involving travel to patients homes treatment facilities and community-based settings and assigned clinics to facilitate connections.
Workstyle: Hybrid - Combination in clinic and field local travel to meet with patients
Location: Must reside in designated Jacksonville FL metro
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.
Tuberculosis (TB) screening: This role is considered member facing and is part of Humanas Tuberculosis (TB) screening program. If selected for this role you will be required to be screened for TB.
Drivers License Reliable Transportation Insurance This role is part of Humanas Driver safety program and therefore requires an individual to have:
- a valid state drivers license
- carry insurance in accordance with the state minimum required limits or $25000/$25000/10000 whichever is higher
- and a reliable vehicle.
Scheduled Weekly Hours
40Pay 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.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
About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive preventive care to seniors including wellness visits physical exams chronic condition management screenings minor injury treatment and more. As part of CenterWell Senior Primary Care Convivas innovative value-based approach means each patient gets the best care when needed most and for the lowest cost. We go beyond physical health addressing the social emotional behavioral and financial needs that can impact our patients well-being.About CenterWell a Humana company: CenterWell creates experiences that put patients at the center. As the nations largest provider of senior-focused primary care one of the largest providers of home health services and fourth largest pharmacy benefit manager CenterWell is focused on whole-person health by addressing the physical emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM) CenterWell offers stability industry-leading benefits and opportunities to grow yourself and your career. We proudly employ more than 30000 clinicians who are committed to putting health first for our teammates patients communities and company. By providing flexible scheduling options clinical certifications leadership development programs and career coaching we allow employees to invest in their personal and professional well-being all from day one.
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.
Required Experience:
Manager
Employment Type
Full-Time
