RN, Field Care Manager (Adults and Pediatrics) jobs in United States
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Humana · 1 month ago

RN, Field Care Manager (Adults and Pediatrics)

positionUnited States
timeFull-time
remoteRemote
seniorityEntry, Mid Level
money$71K/yr - $98K/yr
date2+ years exp

Humana is committed to putting health first, and they are seeking an RN, Field Care Manager to conduct assessments for adult and pediatric members. The role involves managing a caseload, developing care plans, and collaborating with various stakeholders to ensure optimal member outcomes.

Health CareHealth InsuranceInsuranceVenture Capital
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H1B Sponsor Likelynote

Responsibilities

Responsible for managing a case load and completing assessments with members in their home or community-based setting, as well as telephonically
Provides clinical support and guidance, particularly for members with medical complexity
Develops and coordinates care plans ensuring that patients receive appropriate services to manage their health needs effectively
Addresses barriers to health care and advocating for optimal member outcomes
Reviews, assesses, and completes medical complexity attestations and clinical oversights
Ensures members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs
Develops and modifies Individual Care Plan and involve applicable members of the care team in care planning (Informal caregiver, coach, PCP, etc.)
Focuses on supporting members and/or caregivers utilizing an interdisciplinary approach in accessing social, housing, educational and other services, regardless of funding sources to meet their needs
Collaborates with Community Health Workers (CHW), Housing Specialist and other internal and external agencies for HRSN needs
Primary point of contact for the ICT and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met

Qualification

Active RN licenseCase management experienceComplex medical conditionsComputer skillsElectronic medical recordsCommunication skillsAdvocacy for membersBilingualMultilingualCommunity resourcesInterpersonal skillsWork independently

Required

Must reside in the Commonwealth of Northern Virginia
Active Registered Nurse (RN) license in the Commonwealth of Virginia without disciplinary action
Two (2) years of prior experience in health care and/or case management
One (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria *(adults, pediatrics populations at risk for chronic medical conditions and high social needs).*
Strong advocate and respect for members at all levels of care
Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook
Ability to use a variety of electronic information applications/software programs including electronic medical records
Exceptional oral and written communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders
Ability to work with minimal supervision within the role and scope
Ability to work a full-time schedule

Preferred

Prior experience with Medicare, Medicaid and dual eligible populations
Bachelor's Degree Nursing (BSN)
Case Management Certification (CCM)
Experience with health promotion, coaching and wellness
Knowledge of community health and social service agencies and additional community resources
Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance

Benefits

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
Many other opportunities

Company

Humana

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Humana is a health insurance provider for individuals, families, and businesses.
dateFounded in 1964
location
Louisville, Kentucky, USA
people-size10001+ employees
web-link
http://www.humana.com

H1B Sponsorship

Humana has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)

Funding

Current Stage
Public Company
Total Funding
$13.07B
2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B

Leadership Team

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Jim Rechtin
CEO and President
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Colin Drylie
Senior Vice President, Experience Transformation
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Recent News

Benzinga.com
House Passes Bill Extending Health Care Subsidies Despite GOP Leadership Opposition
2026-01-09
TradingView
Humana dips as Wells Fargo downgrades to "equal weight"
2026-01-07
PR Newswire
Leading Health Plans Become CAQH Owners to Shape the Future of Healthcare Data
2026-01-06
Company data provided by crunchbase