Join to apply for the RN Care/Case Manager role at Conviva Senior Primary Care
Pay Range
$71,100.00/yr - $97,800.00/yr
Job Overview
Working within an interdisciplinary care team, the Care Navigator is responsible for proactively engaging patients identified as high‑risk and implementing targeted interventions to address social needs and increase access to care. The Care Navigator will provide guidance and oversight of care coordination efforts to other members of the team, and handle clinical escalations as indicated.
This role requires an understanding of how socio‑economic stressors can impact ability to engage in healthcare and subsequent health outcomes. Experience will ideally include prior work with patients with behavioral health diagnoses, as well as in navigating local community‑based resources and benefit applications.
This role has a mobile presence, involving travel to patients’ homes, treatment facilities and community‑based settings, and assigned clinics to facilitate and foster connections.
Responsibilities
Conduct Transitions of Care Management for a subset of the patient population, including hospital, observation, and post‑acute care follow‑ups
Provide triage guidance and supportive consultation to other team members, handling escalated complex cases
Develop care plans leveraging 5Ms Geriatric best practice framework
Develop a holistic view of patient needs related to Social Determinants of Health
Identify existing barriers to engagement with necessary resources and supports
Provide education around maintenance of chronic health conditions, as well as available options for behavioral care and social support
Serve as liaison between the patient and the direct care providers, assisting in navigating both internal and external systems
Initiate care planning and subsequent action steps for high‑risk members, coordinating with interdisciplinary team
Support patients’ self‑determination, motivate patients to meet the health goals they have identified
Refer patient to necessary services and support across the interdisciplinary team, including transportation, food insecurity, benefit application assistance, medication cost reduction, appointment scheduling, and alleviating social isolation
Lead Interdisciplinary CIT Team Meetings when indicated
Assess patient’s family and caregiver system, and conduct family meetings with patient and family when needed
Participate in creation and facilitation of team training content
Participate in and lead CIT interdisciplinary review of and coordination around complex patients
Maintain patient confidentiality in accordance with HIPAA
Document patient encounters in medical record system in a timely manner
Follow general policies related to fire safety, infection control and attendance
Perform all other duties and responsibilities as required
Required Qualifications
Registered Nurse (RN license) in Florida or Compact
Minimum of 4 years of experience working in human services and navigating community‑based resources
Preferred Qualifications
Familiarity with state Medicaid guidelines and application processes
Experience working with patients with behavioral health conditions and substance use disorders
Prior experience conducting home visits and knowledge of field safety practices
Skills & Competencies
Advanced clinical acumen
Ability to multi‑task in a fast‑paced work environment
Flexibility to fluidly transition and adjust in an evolving role
Excellent organizational skills
Advanced oral and written communication skills
Strong interpersonal and relationship building skills
Compassion and desire to advocate for patient needs
Critical thinking and problem‑solving capabilities
Working Conditions
This role has a mobile presence, involving travel to patients’ homes, treatment facilities and community‑based settings, and assigned clinics to facilitate connections. Combination of clinic and field, local travel to meet with patients.
Location
Must reside in the Ormond Beach, FL area.
Hours
Must be able to work a 40‑hour work week, Monday through Friday 8:00 AM to 5:00 PM. Overtime may be requested.
Driver Safety
Valid state driver’s license
Proof of personal vehicle liability insurance with at least 100/300/100 limits
Reliable vehicle
Benefits
Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. This policy applies to all employment actions.