Bilingual Registered Nurse Field Care Manager - HCBS/LTSS
$71.1k - $97.8k/yr+ $5,000 sign-on bonus + Performance-based bonus incentive
Mid
Bachelor's
Michigan, USA
HybridMust reside in Michigan and travel within Wayne and/or Macomb Counties; occasional office visits may be required.
Medical, Clinical & Veterinary
About the job
Requirements
- Must reside in Michigan, in Wayne or Macomb Counties.
- Must hold an active Michigan Registered Nurse or Advanced Practice Registered Nurse license, including Nurse Practitioner or Clinical Nurse Specialist, with no disciplinary actions.
- Must speak, read, and write English and Arabic or Chaldean independently and without assistance.
- Must have experience with Home and Community-Based Services and waiver programs.
- Must have at least 2 years of experience in healthcare and/or case management.
- Must have experience conducting Long-Term Services and Supports assessments, working with Medicaid regulations, and applying person-centered planning principles.
- Must have experience collaborating with interdisciplinary teams, providers, members, and caregivers to complete comprehensive assessments and recommend appropriate services.
- Must maintain timely, accurate, and compliant documentation in accordance with organizational, state, and federal requirements.
- Must have knowledge of community health, social service agencies, and community resources.
- Must be able to use electronic information systems and software programs, including electronic medical records.
- Must have intermediate to advanced computer skills, including Microsoft Word, Outlook, and Excel, as well as keyboarding and web navigation skills.
- Must complete tuberculosis screening if selected.
- Must have a valid state driver's license and personal vehicle liability insurance meeting the applicable minimum coverage requirements.
- Must meet the minimum home internet speed requirements of 25 Mbps download and 10 Mbps upload and work from a dedicated space that protects member health information.
Responsibilities
- Manage a caseload and complete member assessments in home, community-based, and telephonic settings.
- Provide clinical support and guidance, particularly for members with complex medical needs.
- Develop and coordinate care plans to ensure members receive appropriate services to manage their health effectively.
- Address barriers to healthcare and advocate for optimal member outcomes.
- Review, evaluate, and complete medical complexity attestations and clinical oversight activities.
- Assess care needs to ensure members receive services in the least restrictive setting and achieve or maintain optimal well-being.
- Develop and update the Individual Care Plan with applicable care team members, including informal caregivers, coaches, and primary care providers.
- Use an interdisciplinary approach to help members and caregivers access social, housing, educational, and other services, regardless of funding source.
- Serve as the primary contact for the Interdisciplinary Care Team, coordinating with the member, team participants, and external resources to ensure members’ needs are met.
- Conduct comprehensive InterRAI Integrated Health Care assessments and Nursing Facility Level of Care Determinations to evaluate members’ clinical, functional, cognitive, behavioral, and psychosocial needs; support accurate eligibility decisions and person-centered care planning; and ensure compliance with state Medicaid, Long-Term Services and Supports, Home and Community-Based Services waiver, and regulatory requirements.
- Travel within Wayne and/or Macomb Counties to conduct in-home member visits; travel is expected 75%–90% of the time.
- Travel from home to the first work location, between client or assignment locations, and from the final work location back home is eligible for mileage reimbursement.
Desired Qualifications
- A Bachelor of Science in Nursing is preferred.
- Experience completing InterRAI Integrated Health Care assessments, including assessment methodology, care planning, and identification of clinical, functional, cognitive, and psychosocial needs.
- Experience conducting and documenting Nursing Facility Level of Care Determinations in accordance with state Medicaid, Long-Term Services and Supports, and regulatory requirements.
- Experience in health promotion, coaching, and wellness.
- Previous experience in managed care.
About the company
Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.
Company Size
10,001+
Company Stage
IPO
Headquarters
Louisville, Kentucky
Founded
1961
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Simplify's Take
What believers are saying
- Enrollment is surging: in July 2026 Humana affirmed about 25% individual Medicare Advantage membership growth for 2026.
- Owned clinics create clinical careers: CenterWell Senior Primary Care added 130,900 patients, up 27%, in early 2026.
- Medicaid is widening: Illinois chose Humana in June 2026 to run Medicaid coverage statewide.
What critics are saying
- Low quality scores cut Medicare bonuses: only 20% of Humana's members sat in 4-star or better plans for 2026.
- The insurer is shrinking to save margins: about 600,000 Medicare Advantage members got plan-closure notices in October 2026.
- Stock grants carry risk: in July 2026 Humana cut its 2026 GAAP earnings floor to $6.52 a share from $8.36.
What makes Humana unique
- Military families are a second market: Humana runs the Pentagon's TRICARE health plan across 24 eastern states and Washington, DC.
- Florida anchors the business: Humana's Medicare Advantage contracts there produced 14% of its 2025 revenue.
- Medicaid is a quiet second insurer: Humana covers over 1.54 million low-income members across 11 states.
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Benefits
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Disability Insurance
- Unlimited Paid Time Off
- Paid Vacation
- Paid Parental Leave
- Short-term Disability
- Long-term Disability
- 401(k) Retirement Plan
- 401(k) Company Match