Care Manager, Telephonic Nurse

Humana • Madison, WI

6h • Remote

About The Position

Become a part of our caring community Make a meaningful impact on the lives of Wisconsin Medicaid members by joining Humana as a Care Management Telephonic Nurse. You will be part of a collaborative, interdisciplinary team dedicated to supporting individuals with complex medical, behavioral health, and social needs. You'll work closely with providers, behavioral health specialists, and community organizations to deliver coordinated, high-quality care that truly makes a difference. Through comprehensive assessments, personalized care planning, and ongoing support, you'll help ensure members receive the right care at the right time—all while promoting efficient, cost-effective solutions. You'll report directly to the Manager of Care Management and help improve health outcomes across the communities you serve.

Requirements

• Bachelor's degree.
• Licensed Registered Nurse (RN) in the State of Wisconsin, with no disciplinary action.
• Two (2) years of healthcare experience as an RN.

Nice To Haves

• Bilingual in English/Spanish.
• Experience with case management, discharge planning and patient education for adult acute care.
• Managed care experience.
• Certified Case Manager (CCM).

Responsibilities

• Assist Care Managers in the oversight, development, and prioritization of member care plans addressing complex medical, behavioral health, and social needs.
• Monitor member status and direct members to appropriate specialty services, community resources, and alternative treatment settings.
• Participate in coordinating member discharge needs in collaboration with facility discharge planners, Care Coordinators, Care Managers, and behavioral health personnel, and assists with medical transitions of care.
• Coordinate services, communicate clinical information, and interface with health care providers regarding the management of current medical, behavioral health, and social needs.
• Support the high risk and complex case management team with completing comprehensive assessments and managing members
• Educate on chronic conditions and preventive health measures
• Problem‑solve with staff, members, and providers to identify appropriate alternatives or solutions to care needs.
• Participate in interdisciplinary team meetings as a member or facilitator.
• Serve as a clinical resource to iCare staff and assist with training and mentoring of employees.
• Support program development and procedure enhancements, and provide input to Quality Improvement and Quality Assurance programs.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level