Case Manager

Humana • Milwaukee, WI

21d • Hybrid

About The Position

Join the Humana team as a Case Manager, providing care coordination, support, and education to members enrolled in Medicaid, BadgerCare, and SSI. This role is primarily remote, but requires approximately 50% travel to visit members in their homes or community settings throughout the Southeastern Wisconsin area. You will conduct comprehensive assessments, develop and implement individualized care plans, perform ongoing reassessments, and coordinate services to ensure continuity of care. Documentation, member education on health measures, and collaboration with healthcare professionals and community agencies are key aspects of this position.

Requirements

• Bachelor's degree in health and human services field.
• 2 or more years of experience in case management.
• Must have a private room with a locked door that can be used as a home office to ensure privacy while you work.
• Must reside in the southeastern WI area.
• Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
• Minimum download speed of 25 Mbps and an upload speed of 10 Mbps for internet service; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership.
• Ability to work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• License in health and human services field (CSW, LPC, LPC-IT, OT-A).
• Bilingual in English/Spanish.
• Behavioral Health experience.
• Experience working in a managed care organization.
• Prior experience with Medicare & Medicaid recipients.

Responsibilities

• Conduct comprehensive Medicaid-required psychosocial and functional assessments to identify member needs, risks, strengths, and barriers affecting health and independence.
• Develop, implement, coordinate, and monitor individualized, person‑centered care plans following Medicaid program requirements, ensuring services and supports align with member‑identified goals and outcomes.
• Perform ongoing reassessments and care plan updates at required intervals and as member needs change, monitoring health status, safety, service effectiveness, and progress toward desired outcomes.
• Conduct required face‑to‑face visits with members in their homes or community settings to assess needs, evaluate service delivery, provide education, and support member engagement in care.
• Coordinate and monitor Medicaid-covered services, and community‑based resources to ensure access, continuity of care, and avoidance of service gaps.
• Document assessments, face‑to‑face visits, care plans, member interactions, and service coordination activities following Medicaid, contractual, and organizational documentation standards.
• Educate members on preventive health measures, wellness strategies, and care adherence to support improved health outcomes and compliance with Pay for Performance (P4P) quality measures.
• Build collaborative relationships with members, families, caregivers, providers, and community agencies to promote engagement, and care coordination.
• Collaborate with physicians, interdisciplinary care teams, and other healthcare professionals to coordinate and integrate medical, behavioral, and social services.
• Educate members and providers regarding Medicaid benefits, covered services, provider roles, and appropriate use of healthcare services; refer members to community resources and social services.

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
• Mileage reimbursement is provided for work-related travel.
• Telephone equipment appropriate to meet the requirements for their position/job will be provided.

What This Job Offers

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