RN Case Manager

HumanaBaraboo, WI
7dRemote

About The Position

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance—no nights or weekends, giving you more time for what matters most. Humana is currently seeking an RN Case Manager to join our team, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana. Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Requirements

  • Associate degree in nursing.
  • Must be a Registered Nurse, licensed in the state of Wisconsin in good standing.
  • Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications.
  • 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.

Nice To Haves

  • Bachelors degree in nursing.
  • Experience with Family Care target group: frail elders and adults with intellectual, developmental, or physical disabilities.
  • Care Management experience.

Responsibilities

  • Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan.
  • Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care plans that support their continued health and safety.
  • Contribute to the creation, continuous evaluation, and coordination of the member's plan of care, including coordinating with outside providers to provide support with medication administration, assistance with home care, skilled nursing visits, and related services to ensure comprehensive care.
  • Contact and coordinate with acute and primary care providers.
  • Promote health and wellness through patient education on disease prevention, nutrition, exercise and lifestyle modifications.
  • Provide members with education and information about disease processes and related risks, supporting informed decision-making while respecting each individual's autonomy.
  • Daily documentation in member files within required DHS contract timeframes.
  • Participate in member monthly phone contacts and attend in person visits in members setting.
  • Traveling will be required and eligible for mileage reimbursement.

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.
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