RN Care Manager Lead

Humana • Kenosha, WI

6d • $71,100 - $97,800 • Hybrid

About The Position

Humana/iCare is looking for an RN Care Manager Lead to join the growing team in the Family Care Partnership (FCP) program. Reporting to the Manager of Care Management, you will provide lead care management services through the FCP program. You will also provide support to the FCP Nurses and Care Coaches in a mentoring capacity. You will work with the Interdisciplinary Team (IDT) to guide and support them in serving FCP members to provide health care, behavioral health, and social services to meet identified complex and episodic medical, psychiatric, and social needs of the population. Share your talents and develop your leadership skills all while doing your part to improve the lives of others.

Requirements

• Registered Nurse, licensed in the State of Wisconsin and in good standing.
• Travel approximately 20% of your time throughout the Kenosha, Racine, Milwaukee, Waukesha, Walworth, Washington, and Sheboygan.
• 2 years of Managed Care experience
• 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 is required; wireless, wired cable or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Bi-lingual skills- English & Spanish
• Training or mentoring experience
• Knowledge of community health and social service agencies and additional community resources

Responsibilities

• Arrange for shadowing experiences in the field and application for new care managers and nurses during their orientation period.
• Communicate with the appropriate manager regarding an employee's participation and progress in mentoring activities.
• Provide education and coaching on the CM and RN role and teamwork within the Interdisciplinary Team including specific responsibilities as it relates to contractual compliance per discipline.
• Help provide ongoing training for staff to develop proficiency and advanced knowledge in the Family Care model and other supplementary best practices following the Employee Development Plan and other projects that develop.
• Collaborate with Leadership to identify external trainings needed to support/enhance best practices. Coordinate and implement external trainings needed and ensure effectiveness of training.
• Conduct nursing assessment as part of the initial comprehensive assessment and reassessment process.
• Use the Resource Allocation Decision making methodology (RAD)
• Coordinate and monitor services and resources implemented to meet members' identified outcomes and members progress toward meeting those outcomes.
• Conduct periodic RN reassessment and updates of the member's care plan and monitor the member's health and safety.
• Assist members and their families to identify other service needs and gain access to medical, social, rehabilitation, vocational, educational and other services identified to achieve outcomes.
• Assist members or members' representatives in filing complaints, grievances and obtaining advocacy services.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

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