Become a part of our caring community and help us put health first

Role Overview

• Responsible for health risk assessments along the continuum of care for members.

• Assesses members creates individualized care plans and attends interdisciplinary care team meetings.

• Employs a variety of strategies approaches and techniques to manage a members physical environmental and psycho-social health issues.

• Identifies and resolves barriers that hinder effective care.

• Ensures members are progressing towards desired outcomes by continuously monitoring their care through assessments and/or evaluations.

• 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.

• Collaborates with internal and external providers or departments to meet the members needs.

• Meets requirements for contractual and regulatory compliance.

• Follows established guidelines/procedures.

Use your skills to make an impact

Required Qualifications

• Must reside in the Northern/Winchester Region in the Commonwealth of Virginia and travel to see members in region-based facilities and homes for face-to-face assessments and interactions with members and/or the counties/independent cities of Winchester Frederick Clarke Warren Shenandoah Page Rappahannock Culpeper Fauquier Prince William Fairfax Fairfax City Alexandria Arlington Falls Church Loudoun Manassas and Manassas Park.

• Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action.

• 2 years of prior experience in health care and/or case management.

• 1 year of acute care experience working in obstetrics womens care labor and delivery mother baby NICU and/or clinical triage.

• Knowledge of community health and social service agencies and additional community resources.

• Intermediate to advanced computer skills and experience with Microsoft Word Outlook and Excel with the ability to use a variety of electronic information applications/software programs including electronic medical records. Excellent keyboard and web navigation skills.

• 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 travel to region-based facilities and homes for face-to-face assessments and interactions with members and/or families.

Preferred Qualifications

• Bachelors of Science in Nursing (BSN).

• 3-5 years of in-home assessment and care coordination experience.

• Lactation experience preferably as a certified lactation consultant.

• Experience with health promotion coaching and wellness.

• Previous managed care experience.

• Certification in Case Management (CCM).

• Motivational Interviewing Certification and/or knowledge.

• Bilingual or Multilingual: English/Spanish Arabic Vietnamese Amharic Urdu or other - Must be able to speak read and write in both languages without limitations or assistance. See Additional Information for more information.

Work At Home Requirements

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 required.

• Satellite cellular and microwave connection can be used only if approved by leadership.

• 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.

• 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.

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.

Workdays and Hours: 40 hours a week - Monday Friday; 8:00am 5:00pm Eastern Standard Time (EST).

Travel: 50 - 75% region-based travel to meet with members their families and providers. May need to attend occasional onsite meetings in Humana Healthy Horizons office in Glen Allen VA. This role is part of Humanas driver safety program and therefore requires an individual to have a valid state drivers license and are expected to maintain personal vehicle liability insurance.

Insurance: Individual must carry vehicle insurance in accordance with their residing state minimum required limits or $25000 bodily injury per person/$25000 bodily injury per event /$10000 for property damage or whichever is higher.

Screening: This role is considered patient facing and is part of Humanas Tuberculosis (TB) screening program. If selected for this role you will be required to be screened for TB.

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.

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.

Social Security Task

Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number if it is not already on file. When required an email will be sent from with instructions to add the information into the application at Humanas secure website.