Humana

Become a part of our caring community   The Field Care Manager Registered Nurse (RN) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members and families toward resources appropriate for the care and wellbeing of members. The Field Care Manager Nurse employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. The Field Care Manager Registered Nurse key roles and responsibilities may include the following: Identifies and resolves barriers that hinder effective care. Ensures member is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. Create plans of care. Communicates with internal and external stakeholders. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Follows established...

Become a part of our caring community   The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Support Humana’s values by working collaboratively and effectively within a team-based environment. Apply medical training, clinical experience, and professional judgment to determine whether requested services, levels of care, or sites of service should be authorized. Ensure all determinations are made within a regulatory compliance framework and are supported by appropriate resources, which may include national clinical guidelines, state policies, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other applicable resources. Learn and apply Medicaid requirements, including the...