What are the responsibilities and job description for the Nurse Case Manager position at Humana?
Position Overview:
The Field Care Manager Nurse plays a vital role in our healthcare team, assessing and evaluating members' needs to achieve optimal wellness. This position involves guiding members and families towards resources that cater to their care and well-being.
Main Responsibilities:
- Utilize evidence-based substance use services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical, behavioral health, and ARTS providers.
- Provide comprehensive, integrated support to members experiencing substance use and possible co-occurring conditions, including children, adolescents, adults, and justice-involved members.
- Engage members in their communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination.
- Complete all required assessments, including the Comprehensive Risk Assessment (CHRA).
- Coordinate behavioral health, substance use, and medical services, ensuring appropriate provider engagement and adherence to treatment plans.
- Improve member's health literacy while simultaneously addressing health-related social needs to positively impact member's healthcare outcomes and well-being.
- Serve as the quarterback of the member's interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery.
- Facilitate ICT meetings, ensuring seamless communication among providers, Service Coordinators, and Care Management Extenders.
- Engage in biannual and quarterly face-to-face visits, ensuring continuous monitoring and proactive intervention.
- Must be able to work with autonomy but reach out when support is needed.
- Collaborate with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members' preferences and needs.
