Case Manager- Dodge County

Humana•Watertown, WI

1d•Remote

About The Position

Join Humana as a Case Manager within the Inclusa/Humana team, where you will serve members in the Wisconsin Family Care (FC) program. Reporting to the Manager of Care Coaching, you will provide comprehensive case management services to frail elders and adults with intellectual, developmental, or physical disabilities. Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum. Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.

Requirements

A Bachelor's degree in human services or a related field with at least 1 year of experience serving frail elders or adults with intellectual, developmental, or physical disabilities, OR a Bachelor's degree in another field with at least 3 years of such experience.
Valid state driver's license.
Proof of personal vehicle liability insurance with at least 100/300/100 limits.
Self-provided internet service with at minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

Reside within 45 mins or less of the assigned coverage area.
Case Management experience.
Experience with electronic case note documentation.
Knowledge of community health and social service agencies and additional community resources.

Responsibilities

Assess members health and safety needs to identify their strengths, interests, and preferences to develop a comprehensive Member Care Plan (MCP).
Coordinate with a Field Care Nurse to provide services that address members' health and safety needs, ensuring the team provides support in the least restrictive environment following the MCP.
Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence.
Conduct quarterly in-person visits and maintain monthly contact with members by phone.
Arrange support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs.
Ensure cost-effective service delivery.
Evaluate risk factors and provide education to members.
Maintain accurate documentation including case notes, service authorizations, and updates to the MCP.

Benefits

Medical benefits
Dental benefits
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 disability
Long-term disability
Life insurance
Mileage reimbursement is provided for work-related travel.
Bi-weekly payment for internet expense (for employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota).
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.