FCP Case Manager- Madison

Humana • Madison, WI

1d • $53,700 - $72,600 • Hybrid

About The Position

Humana/iCare is looking for a Case Manager to join the Dane County team in the Family Care Partnership (FCP) program. This role provides care management services through the FCP program, including assessment, service plan development, ongoing care coordination, quality assurance, and ongoing monitoring of services to adults with disabilities and the frail elderly. The Case Manager will collaborate with the Interdisciplinary Team (IDT) and other Partnership staff to assist members and their families in identifying service needs and accessing medical, social, rehabilitation, vocational, educational, and other services to achieve desired outcomes. This position offers an opportunity to develop skills while improving the lives of others.

Requirements

• Social Worker certified in Wisconsin with a minimum of one (1) years' working with at least one of the Family Care target group populations.
• 4-year bachelor's degree or more advanced degree in the Human Service area and a minimum of one (1) years' experience working with at least one of the Family Care target populations.
• 4-year bachelor's degree or more advanced degree in any area other than human services with a minimum of three (3) years' experience working with at least one of the Family Care populations.
• Knowledge of the community resources available to meet the needs of the members and a thoughtful understanding of the range and type of long term care options available in the community.
• Ability to travel to any location within Dane County and the surrounding areas to conduct assessments within members' residences.
• 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.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Certification or Licensure in Social Work in the State of Wisconsin or be eligible for Certification and Licensure.
• Previous managed care experience.
• General knowledge of Medicaid and Medicare benefits.

Responsibilities

• Conduct psychosocial assessments as part of the comprehensive assessment process.
• Utilize the Resource Allocation Decision making methodology (RAD), help member identify their preferred outcomes and potential strategies to achieve those outcomes, including through the identification of community resources and cost-effective services or equipment.
• Coordinate and monitor services and resources implemented to meet member's identified outcomes and member's progress toward meeting those outcomes.
• Conduct periodic reassessment and updates of the member's care plan and monitor member's health and safety.
• Assist member or member's representative in filing complaints, grievances and obtaining advocacy services.
• Document member information and contacts made regarding member's care and services provided.
• Create documentation according to procedure, workflows, audit requirements and time frames.
• Build constructive working relationships with the member, their family members, and appropriate outside agency staff.
• Facilitate collaboration with the member's physician or appropriate medical professionals to coordinate member's care.
• Help with problem resolution between member and providers.
• Educate member and providers regarding benefits, service providers and protocols to access resources and the appropriate use of medical services. Provide referrals for community resources and social services.
• Monitor member's willingness to engage in treatment regimes, and work with staff, member and providers to find alternatives or solutions to their needs.

Benefits

• Medical benefits
• Dental benefits
• Vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term disability
• Long-term disability
• Life insurance
• Mileage reimbursement

What This Job Offers

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