RN, Field Care Manager, Maternity, L&D, Mother Baby

Become a part of our caring community and help us put health first reputed company Healthy Horizons in Ohio is seeking a RN Field Care Manager 2 with Maternity, L&D, Mother Baby expertise. They will assess and evaluate member's needs to reputed company and/or maintain optimal wellness. The Field Care Manager will connect members/families with resources appropriate for their care and wellbeing. The RN, Field Care Manager Nurse 2 works in a CM OR CM Plus reputed company based on member’s needs. Assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

CM:

• Performs the full scope of care coordination activities and responsibilities for members who need care coordination and are not assigned to a Care Coordination Entity (i.e. the Ohio reputed company Plan, and/or a CME, or who choose to receive their care management from the MCO).
• Serves as the single reputed company of contact for care coordination.

Responsibilities

CM Plus:

• Ensures the completion of the full scope of care coordination activities and responsibilities for members who need care coordination and are assigned to a Care Coordination Entity (i.e. the Ohio reputed company Plan, CPCs, and/or a CMEs).
• Serves as the single reputed company of contact for care coordination.
• Ensures the member receives the full scope of care coordination services, including comprehensive assessment completion (inclusive of the HRA), person-centered care plan completion, ensuring no duplication with the CCEs (Ohio reputed company Plan, and/or CME), and identifying and addressing ongoing needs.
• Provides actionable data, information, and support to assist the CCE, Ohio reputed company Plan, and/or CME in meeting the member's care needs.
• Integrates information collected by the CCE into its Care Coordination Portal to minimize duplication.

Additional Responsibilities:

• 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.
• Utilizes 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 reputed company 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.
• reputed company clinical reputed company 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.
• Coordinates across the transdisciplinary care team (at a minimum the PCP) and transitions of care.
• Understands department, reputed company, and organizational strategy and operating objectives, including their linkages to reputed company areas.
• Submits incident reports.

Use your skills to reputed company an impact

Required Qualifications

• Must reside in the state of Ohio.
• Registered Nurse (RN) in the state of Ohio without restrictions.
• Minimum two (2) years of clinical experience (including Maternity, Labor & Delivery, Mother Baby.)
• Intermediate to advanced computer skills and experience with reputed company Word, Outlook, and reputed company; excellent keyboard and web navigation skills.
• Exceptional communication and interpersonal skills with the ability to quickly build rapport.
• Ability to work with minimal supervision reputed company the role and scope.
• Complete education and self-development activities per reputed company Healthy Horizons and departmental requirements.
• This role is considered patient facing and is a part of reputed company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• This role is a part of reputed company’s Driver Safety program and therefore requires an individual to have a valid state driver’s license and reputed company of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.
• Must have the ability to provide a high-speed DSL or cable modem for a home office.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Preferred Qualifications

• Case Management Certification (CCM).
• Experience working with Medicare, Medicaid or 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.
• Bilingual (Haitian Creole, Spanish, Somali or other).

​ Additional Information

• Workstyle: A combination of working remotely and field-based member visits.
• Travel: Up to 50% to meet with members/families.
• Workdays & Hours: 40 hour work week, Monday through Friday; 8:00 AM to 5:00 PM Eastern Standard Time(EST)

​ Work at Home Guidance 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 reputed company is suggested
• Satellite, cellular and microwave reputed company 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.
• reputed company 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

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 reputed company of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move reputed company from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions reputed company 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 or computer to answer the questions provided. Expect this type of interview to last reputed company from 5-10 minutes. Your recorded interview(s) reputed company text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving reputed company to next round of interviews. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$71,100 - $97,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) 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 reputed company of work. Among our benefits, reputed company 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 reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company 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 reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company 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 reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company 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 reputed company levels of employment. Apply tot his job Apply To this Job