Case Manager- Madison

Humana • Madison, WI

6d • Remote

About The Position

Become a part of our caring community and help us put health first Humana/iCare is seeking a Care Coach to join the growing Dane County team in the Family Care Partnership (FCP) program. The FCP Care Coach provides care management services through the FCP program including assessment, service plan development, ongoing care coordination, quality assurance and ongoing monitoring of services to adults with disabilities and the frail elderly. Share your talents and develop your skills all while doing The FCP Care Coach works collaboratively with the Interdisciplinary Team (IDT) and other Partnership staff to assist members and their families with identifying service needs and gaining access to medical, social, rehabilitation, vocational, educational, and other services to achieve members’ desired outcomes.

Requirements

• The Care Coach must meet one of the following qualifications: Social Worker certified in Wisconsin with a minimum of one (1) years’ experience working with at least one of the Family Care target group populations.
• 4-year bachelor’s degree or more advanced degree in the Human Service area and a minimum of one (1) years’ experience working with at least one of the Family Care target populations.
• 4-year bachelor’s degree or more advanced degree in any area other than human services with a minimum of three (3) years’ experience working with at least one of the Family Care populations.
• The Family Care target group population is defined as: Frail Elders, Adults with physical disabilities, or intellectual/developmental disabilities
• The Care Coach must meet all of the following qualifications: Knowledge of the community resources available to meet the needs of the members and a thorough understanding of the range and type of long term care options available in the community.
• Ability to travel to any location within Racine and Kenosha Counties to conduct assessments within members’ residences.
• Previous experience working with Microsoft Outlook, Word, Teams, and Excel.
• This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
• This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Nice To Haves

• Certification or Licensure in Social Work in the State of Wisconsin or be eligible for Certification and Licensure.
• Previous managed care experience.
• General knowledge of Medicaid and Medicare benefits.

Responsibilities

• Conduct psychosocial assessments as part of the comprehensive assessment process.
• Utilize the Resource Allocation Decision making methodology (RAD), help member identify their preferred outcomes and potential strategies to achieve those outcomes, including through the identification of community resources and cost-effective services or equipment.
• Coordinate and monitor services and resources implemented to meet member’s identified outcomes and member’s progress toward meeting those outcomes.
• Conduct periodic reassessment and updates of the member’s care plan and monitor member’s health and safety.
• Assist member or member’s representative in filing complaints, grievances and obtaining advocacy services.
• Document member information and contacts made regarding member’s care and services provided.
• Create documentation according to policy and procedure, workflows, audit requirements and time frames.
• Build constructive working relationships with the member, their family members, and appropriate outside agency staff.
• Facilitate collaboration with the member’s physician or appropriate medical professionals to coordinate member’s care.
• Assist in problem resolution between member and providers.
• Educate member and providers regarding benefits, service providers and protocols to access resources and the appropriate use of medical services.
• Provide referrals for community resources and social services as necessary.
• Actively monitor member’s ability and willingness to engage in treatment regimes, and problem solve with staff, member and providers to find alternatives or solutions to their needs.

Benefits

• Humana provides 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 and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees