Case Manager-Rock/Jefferson

Humana•Janesville, WI

1d•Remote

About The Position

Humana is hiring a Case Manager for its Inclusa/Humana team to serve members in Wisconsin’s Family Care program across Rock and/or Jefferson counties. Reporting to the Manager of Care Coaching, the Case Manager provides comprehensive services to frail elders and adults with intellectual, developmental, or physical disabilities. The position assesses members’ needs and preferences, coordinates services with a Field Care Nurse, and supports members in the least restrictive environment according to their Member Care Plan (MCP). The role involves in-person assessments and visits at members’ homes, ongoing phone contact, arranging community and non-medical supports, evaluating risks, and maintaining case documentation. It is remote, with travel of up to 40% for member visits and occasional travel to Humana offices for training or meetings. Typical hours are Monday through Friday, 8:00 a.m. to 4:30 p.m. CST, with 40 scheduled hours per week.

Requirements

A bachelor’s degree in human services or a related field and at least one 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 three years of such experience.
Ability to travel up to 40% of the time to visit members.
Valid state driver’s license.
Proof of personal vehicle liability insurance with at least 100/300/100 limits.
Meet Humana’s work-at-home internet requirements: at least 25 Mbps download and 10 Mbps upload, with a dedicated workspace free of ongoing interruptions to protect member PHI/HIPAA information.
Complete tuberculosis screening if selected for the role.

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 support them in the least restrictive environment in accordance with the MCP.
Travel to members’ locations to 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 at members’ homes and maintain monthly contact by phone.
Arrange support services 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 MCP updates.