Join Humana as a Case Manager within the Inclusa/Humana team, where you will serve members in the Wisconsin Family Care (FC) program. Reporting to the Manager of Care Coaching, you will provide comprehensive case management services to frail elders and adults with intellectual, developmental, or physical disabilities. Let's make a difference together!
Job Description
Main responsibilities:
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Assess members health and safety needs to identify their strengths, interests, and preferences to develop a comprehensive Member Care Plan (MCP).
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Coordinate with a Field Care Nurse to provide services that address members' health and safety needs, ensuring the team provides support in the least restrictive environment following the MCP.
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Travel to members location to conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence.
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Travel to members home to conduct quarterly in-person visits and maintain monthly contact with members by phone.
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Arrange support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs.
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Ensure cost-effective service delivery.
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Evaluate risk factors and provide education to members.
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Maintain accurate documentation including case notes, service authorizations, and updates to the MCP.
Required Qualifications
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A Bachelor's degree in human services or a related field is required, with 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 with at least 3 years of such experience is also acceptable.
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Travel up to 40% of your time to visit members. Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits
Preferred Qualifications
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Reside within 45 mins or less of the assigned coverage area
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Case Management experience
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Experience with electronic case note documentation
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Knowledge of community health and social service agencies and additional community resources
Additional Information
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Work Location: Sheboygan, WI and surrounding area
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Travel: up to 40%
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Typical Workdays/Hours: Monday – Friday, 8:00 am – 4:30 pm CST
Driving
You will be part of Humana's driver safety program and therefore requires you 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. Eligible mileage includes:
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Travel from your home to your first work location of the day.
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Travel between client or assignment locations during the workday.
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Travel from your final work location back to your home.
TB Screening
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.
Work at Home Requirements: 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.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$53,700 - $72,600 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.
About Inclusa: 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 a leading U.S. healthcare 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
