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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management, including developing individualized care plans and coordinating with healthcare providers. Proficient in assessing member needs and utilizing community resources to promote wellness and recovery.
Highest-signal resume keywords
Active Louisiana Registered Nurse (RN) LicenseTwo Years Clinical Experience in Maternal-Child HealthCase Management Certification (CCM)Experience with Medicare and MedicaidMotivational Interviewing Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AssessmentCare Plan DevelopmentHealth PromotionField Case ManagementTelephonic AssessmentsElectronic Medical RecordsInterpersonal CommunicationProblem SolvingJudgment SkillsCommunity Resource Coordination
Soft Skills
Exceptional Communication SkillsAbility to Work IndependentlyInterpersonal SkillsSound JudgmentEngagement Skills
Tools & Technologies
Microsoft WordMicrosoft OutlookMicrosoft ExcelElectronic Information ApplicationsTelehealth Platforms
Certifications & Qualifications
Case Management Certification (CCM)
Industry Keywords
Maternal-Child HealthLabor & DeliveryPediatricsManaged Care Health PlanCommunity HealthSocial Service AgenciesHealth and Wellness ResourcesDual-Eligible PopulationsLouisiana Department of Health DirectivesHIPAA Compliance
About the role
Key responsibilities & impact- Assess and evaluate members' needs and requirements to achieve or maintain optimal wellness
- Guide members and families toward appropriate care and wellbeing resources
- Manage members' physical, environmental, and psychosocial health issues
- Identify and resolve barriers to effective care
- Engage members and families in recovery and wellness programs using a holistic, member-focused approach
- Conduct telephonic and in-person assessments
- Monitor and evaluate member progress
- Develop individualized care plans using clinical judgment and changes in health status
- Collaborate with providers and community services to ensure quality, cost-effective outcomes
- Coordinate physical health, social determinants of health, and additional benefits
- Facilitate communication across the care team, including PCPs and care transitions
- Provide health and wellness resources to families
- Submit incident reports as required
- Participate in health promotion and community events
- Implement care management activities according to contractual requirements, established guidelines, and Louisiana Department of Health directives
- Conduct face-to-face interactions with members, families, and providers
- Travel within the assigned Louisiana region and attend community engagement activities and team meetings
Requirements
What you’ll need- Must reside in Region 1, 3, or 9 of Southern Louisiana, including Assumption, Jefferson, Lafourche, Livingston, Orleans, Plaquemines, St. Bernard, St. Charles, St. Helena, St. James, St. John, St. Mary, St. Tammany, Tangipahoa, Terrebonne, or Washington parishes
- Active, unrestricted Louisiana Registered Nurse (RN) license
- Two or more years of clinical experience in maternal-child health, Labor & Delivery (L&D), and/or pediatrics
- Intermediate to advanced computer skills
- Experience with Microsoft Word, Outlook, and Excel
- Ability to use electronic information applications/software, including electronic medical records
- Exceptional communication and interpersonal skills
- Ability to work independently with minimal supervision and exercise sound judgment
- Case Management Certification (CCM) or willingness to obtain within two years of employment
- Understanding of current state Maternal/Child Mortality Morbidity
- Basic breastfeeding knowledge
- Experience with Medicare, Medicaid, and dual-eligible populations
- Field Case Management experience
- Managed Care Health Plan experience
- Knowledge of community health and social service agencies and community resources
- Experience with health promotion, coaching, and wellness
- Motivational Interviewing experience
- Must meet home internet requirements of at least 25 Mbps download and 10 Mbps upload
- Must work from a dedicated space protecting member PHI/HIPAA information
Benefits
Comp & perks- Bonus incentive plan based on company and/or individual performance
- Medical, dental, and vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company and personal holidays
- Paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
- Mileage reimbursement for work-related travel
- Remote home office when not conducting community or member visits
- Occasional travel to Humana offices for training or meetings