Case Manager- Eau Claire, WI

Humana Inc. • Eau Claire, WI

48d • Remote

About The Position

Join Humana as a Case Manager in the Eau Claire/Chippewa Falls area and make a real difference within the Inclusa/Humana team by serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities.

Requirements

• Four-year bachelor's degree in human services or related field with one (1) year of experience working with at least one of the Family Care target populations OR a four-year bachelor's degree in any other field with three (3) years' related experience working with at least one of the Family Care target populations.
• Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications.
• The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities
• 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.
• To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Case Management experience
• Experience with electronic case note documentation and experience with documenting in multiple computer applications/systems
• Knowledge of community health and social service agencies and additional community resources

Responsibilities

• Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP).
• Coordinate services that address members' health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP.
• Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members' evolving needs.
• Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence.
• Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone.
• Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs.
• Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery.
• Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness.
• Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan.
• Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes.
• Travel is necessary to conduct member visits and fulfill role responsibilities.

Benefits

• Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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
• Industry: Insurance Carriers and Related Activities
• Number of Employees: 5,001-10,000 employees