RN Field Care Management Team Lead (HCBS & LTSS) Wayne & Macomb Counties

Become a part of our caring community

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.

The Field Care Manager Nurse 2 (Team Lead) employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues.

Position Responsibilities:

• The Field Care Manager Nurse Team Lead partners closely with the Manager of Care Management to drive performance, identify and address barriers, and ensure daily operational excellence in alignment with organizational goals.
• Execute all principal duties of the Field Care Nurse when required, delegating responsibilities as appropriate to optimize team efficiency and effectiveness.
• Oversee daily assignment of Care Coordinators, Community Health Workers (CHW), and CMSA 2 personnel, balancing case load, referral volume, and geographic considerations to meet member needs and organizational goals.
• Proactively assist team members with assignment and case load management, adapting plans as necessary to support changing priorities and workload demands.
• Collaborate with nonclinical associates to facilitate research, conduct nonclinical assessments, address scheduling needs, and ensure comprehensive support for all Interdisciplinary Care Team (ICT) participants, including effective meeting coordination and communication updates.
• Conduct annual onsite visits for field-based associates (Care Coordinator/CHW) to support quality assurance initiatives and deliver targeted training.
• Review and address problems, including conducting onsite assessments as necessary to ensure issues are identified, analyzed, and resolved promptly and effectively.
• Contribute to the development and execution of MI HIDE program strategy and operational efficiency initiatives, actively participating in Experience & Optimization Team efforts.
• Serve as team preceptor and trainer, supporting onboarding, ongoing education, and professional development for associates.
• Act as team SME, providing real-time support to associates via team chat to troubleshoot issues and answer questions, fostering a collaborative and solutions-oriented team environment.

Use your skills to make an impact

Required Qualifications

• Active Michigan Registered Nurse (RN), Nurse Practitioner (NP), or Clinical Nurse Specialist (CNS) license in good standing with no disciplinary actions.

• Must reside in the State of Michigan (Wayne and Macomb Counties)

• Prior care management experience, including leading, mentoring, training, or supporting clinical team members.

• Strong knowledge of Home and Community-Based Services (HCBS), Long-Term Services and Supports (LTSS), Medicaid regulations, and person-centered planning principles.

• Experience with conducting Long-Term Services and Supports (LTSS) assessments, Medicaid regulations, and person-centered planning principles

• Experience providing in-home patient care, including care management, hospice, home health, or a comparable healthcare setting

• Experience working with adult populations, including chronic disease management and patient education

• Knowledge of community health resources, social service agencies, and care coordination services

• Proficiency with electronic health records (EHRs), electronic medical record (EMR) systems, and other healthcare technology applications

• Strong computer skills, including efficient keyboarding, internet research, and web-based navigation

• Intermediate to advanced proficiency in Microsoft Office applications, including Word, Outlook, and Excel

• Strong organizational, communication, and interpersonal skills with the ability to collaborate effectively across multidisciplinary teams

Preferred Qualifications

• Bachelor of Science in Nursing (BSN)

• Previous experience in a lead or supervisory role within a healthcare setting.

• 3-5 years of experience in in-home patient assessment, care coordination, and case management

• Demonstrated experience completing Demonstrated experience completing InterRAI Integrated Health Care (IHC) Assessments with a strong understanding of assessment methodology, care planning, and identification of member needs across clinical, functional, cognitive, and psychosocial domains.

• Proven experience conducting and documenting Nursing Facility Level of Care Determinations (NFLOCDs) in accordance with state Medicaid, LTSS, and regulatory requirements.

• Experience in health promotion, wellness coaching, and patient engagement strategies

• Previous experience working in a managed care environment

• Bilingual proficiency in Spanish, Arabic, or Chaldean Neo-Aramaic

• Certified Case Manager (CCM) or other case management certification

• Motivational Interviewing certification and/or demonstrated knowledge and application of Motivational Interviewing techniques

Additional Information

• Schedule/Time Zone: Monday through Friday, 8:00 AM to 5:00 PM Eastern Time
• Work Location: Michigan (Wayne and Macomb Counties)
• Work Style: Field
• Travel Requirements: 75%- 90% travel within Wayne and/or Macomb Counties, MI

TB Statement: This role is considered patient facing and is part of Humana'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:

• Travel from your home to your first work location of the day.
• Travel between client or assignment locations during the workday.
• Travel from your final work location back to your home.

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 suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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, "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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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.