RN Care Manager- Eau Claire
About The Position
As a RN Care Manager, you will enjoy a true work-life balance with no night or weekend shifts. Reporting to the Manager of Care Coaching, you will support members enrolled in the Wisconsin Family Care Program providing essential care coordination, support, and education. You will make a difference in the lives of those you serve and within your own community. 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. Mileage reimbursement is provided for work-related travel. This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Requirements
- Associate degree in nursing
- Licensed Registered Nurse in the state of Wisconsin (in good standing)
- Valid state driver's license
- 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
- 3 years Care Management experience
- Reside within 45 mins or less of the assigned coverage area
- Previous Care Management experience
Responsibilities
- Assess members, focusing on health and safety needs, to develop a comprehensive Member Care Plan (MCP).
- Conduct regular health assessments
- Coordinate with acute and primary care providers.
- Educate members on disease processes and related risks, nutrition, exercise and lifestyle modifications to support informed decision-making while respecting each person's autonomy.
- Document in member files within required DHS contract timeframes.
- Participate in member monthly phone contacts and travel to attend in person visits in members setting.
- Complete record reviews for reassigned members, including identifying areas where record remediation is needed.
- Provide support regarding record review and remediation. Support the team as they adapt to and navigate this change.
- Complete documentation for remediation
- Ensure that newly assigned RNs and their Care Coach partners are informed of any missing or needed follow-up, including assignment of tasks in the D365 system.
- Accept additional complex member assignments.
- Provide additional support with new member assignments
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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
