Case Manager- Weston

Humana•Weston, WI

11h•Remote

About The Position

The Case Manager serves members in the Wisconsin Family Care (FC) program, providing comprehensive case management to frail elders and adults with intellectual, developmental, or physical disabilities. Reporting to the Manager of Care Coaching, the role assesses members’ health and safety needs and coordinates person-centered supports in the least restrictive environment, consistent with each Member Care Plan (MCP). The position is remote, based in the Weston, Wisconsin coverage area, and includes up to 40% travel. Workdays are Monday through Friday, 8:00 a.m. to 4:30 p.m. CST. Occasional travel to Humana offices for training or meetings may be required. This patient-facing role requires TB screening. The employee must have a valid state driver’s license and personal vehicle liability insurance with limits of at least 100/300/100. Mileage reimbursement is provided for eligible work-related travel, including travel between home and the first and final work locations of the day and between assignment locations. Employees working from home must have internet service with at least 25 Mbps download and 10 Mbps upload speeds and a dedicated work space that protects member PHI/HIPAA information. The estimated starting base pay range for full-time employment is $53,700 to $72,600 per year. Humana offers benefits intended to support employee and family well-being. Inclusa, acquired by Humana in 2022, manages person-centered and community-focused long-term care services and supports for Family Care members across Wisconsin.

Requirements

Bachelor’s degree in human services or a related field and at least 1 year of experience serving frail elders or adults with intellectual, developmental, or physical disabilities; alternatively, a bachelor’s degree in another field and 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.
Ability to complete required tuberculosis screening for this patient-facing role.
For home-based work, internet service with at least 25 Mbps download and 10 Mbps upload speeds and a dedicated workspace that protects member PHI/HIPAA information.

Nice To Haves

Reside within 45 minutes 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, strengths, interests, and preferences to develop a comprehensive Member Care Plan (MCP).
Coordinate with a Field Care Nurse to address members’ health and safety needs and ensure support is provided in the least restrictive environment according to the MCP.
Conduct face-to-face social assessments upon enrollment and at least every six months, typically at the member’s residence.
Conduct quarterly in-person visits and maintain monthly phone contact with members.
Arrange support services for 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 case notes, service authorizations, and MCP updates.