Case Manager- Dane/Columbia

Humana•Madison, WI

4d•Remote

About The Position

Humana is hiring a Case Manager for the Inclusa/Humana team to serve members in Wisconsin’s Family Care program in Dane and Columbia Counties. Reporting to the Manager of Care Coaching, the Case Manager provides comprehensive case management to frail elders and adults with intellectual, developmental, or physical disabilities. The position is remote, with travel to members’ locations and occasional travel to Humana offices for training or meetings. Scheduled hours are Monday through Friday, 8:00 a.m. to 4:30 p.m. CST, for 40 hours per week. The Case Manager assesses members’ health and safety needs, strengths, interests, and preferences and develops a comprehensive Member Care Plan (MCP). In coordination with a Field Care Nurse, the Case Manager arranges appropriate supports, monitors risk, and works to ensure services meet members’ needs in the least restrictive environment. The role includes face-to-face social assessments, in-person visits, monthly phone contact, service coordination, cost-effective service delivery, and maintaining accurate case documentation. Travel may take up to 40% of work time. Work-related mileage is reimbursed. The position is patient-facing and requires TB screening if selected. Employees working from home must use a dedicated space that protects member PHI/HIPAA information and have internet service with at least 25 Mbps download and 10 Mbps upload speeds.

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.
Travel up to 40% of work time to visit members.
Valid state driver’s license.
Proof of personal vehicle liability insurance with at least 100/300/100 limits.

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, and develop a comprehensive Member Care Plan (MCP).
Coordinate with a Field Care Nurse to arrange services addressing 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 phone contact.
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 documentation, including case notes, service authorizations, and MCP updates.