FCP Case Manager

Humana Inc; Racine (WI); Remote; USD 54.000 - 73.000; Vollzeit

Benefits dieser Stelle

Mileage reimbursement

Driver safety program

Zusammenfassung

Humana/iCare seeks a Case Manager to join the GSR3 Family Care Partnership team serving Milwaukee, Racine, Kenosha, and surrounding counties. You will conduct psychosocial assessments, develop care plans, and coordinate ongoing care for adults with disabilities and the frail elderly.

Travel to member residences is required, with up to 75% travel, and occasional in-office work may be needed. This remote role supports field-based responsibilities, including documenting interactions, advocating for

Qualifikationen

• Social work skills and services coordination experience.
• Ability to assess, plan, implement and monitor care plans.
• Strong communication with members, families, and providers.

Aufgaben

• Conduct psychosocial assessments and develop care plans.
• Coordinate and monitor services to meet member outcomes.
• Document care activities and maintain records per policy.
• Collaborate with physicians and providers to coordinate care.
• Educate members and providers about benefits and resources.
• Support member advocacy and navigate care options.

Kenntnisse

Empathy

Communication

Care coordination

Ausbildung

Bachelor's degree in Human Services

Social Work degree or higher

Jobbeschreibung

Become a part of our caring community

Humana/iCare is seeking a Case Manager/ to join the growing GSR3 team (Milwaukee, Racine, Kenosha, Walworth, Waukesha, Washington, Ozaukee, Sheboygan) in the Family Care Partnership (FCP) program. The FCP Case Manager/Care Coach provides care management services through the FCP program including assessment, service plan development, ongoing care coordination, quality assurance and ongoing monitoring of services to adults with disabilities and the frail elderly. Share your talents and develop your skills all while doing your part to improve the lives of others.

Responsibilities

• Conduct psychosocial assessments as part of the comprehensive assessment process.
• Utilize the Resource Allocation Decision making methodology (RAD), help member identify their preferred outcomes and potential strategies to achieve those outcomes, including through the identification of community resources and cost-effective services or equipment.
• Coordinate and monitor services and resources implemented to meet member's identified outcomes and member's progress toward meeting those outcomes.
• Conduct periodic reassessment and updates of the member's care plan and monitor member's health and safety.
• Assist member or member's representative in filing complaints, grievances and obtaining advocacy services.
• Document member information and contacts made regarding member's care and services provided.
• Create documentation according to policy and procedure, workflows, audit requirements and time frames.
• Build constructive working relationships with the member, their family members, and appropriate outside agency staff.
• Facilitate collaboration with the member's physician or appropriate medical professionals to coordinate member's care.
• Assist in problem resolution between member and providers.
• Educate member and providers regarding benefits, service providers and protocols to access resources and the appropriate use of medical services. Provide referrals for community resources and social services as necessary.
• Monitor member's ability and willingness to engage in treatment regimes, and work with staff, member and providers to find alternatives or solutions to their needs.

Use your skills to make an impact

Required Qualifications

The Case Manager must meet one of the following qualifications:

• Social Worker certified in Wisconsin with a minimum of one (1) years' working with at least one of the Family Care target group populations.
• 4-year bachelor's degree or more advanced degree in the Human Service area and a minimum of one (1) years' experience working with at least one of the Family Care target populations.
• 4-year bachelor's degree or more advanced degree in any area other than human services with a minimum of three (3) years' experience working with at least one of the Family Care populations. ***The Family Care target group population is defined as: Frail Elders, Physically Disabled, or Intellectually/Developmentally Disabled***
• Knowledge of the community resources available to meet the needs of the members and a thorough understanding of the range and type of long term care options available in the community.
• Ability to travel to any location within Milwaukee, Walworth, Racine/Kenosha, Waukesha, Washington, Ozaukee, Sheboygan Counties to conduct assessments within members' residences.

Preferred Qualifications

• Certification or Licensure in Social Work in the State of Wisconsin or be eligible for Certification and Licensure.
• Previous managed care experience.
• General knowledge of Medicaid and Medicare benefits.

Additional Information

• Workstyle: Field. Field workstyle is defined as associates performing their core duties at one or more non-Humana/iCare locations.
• Travel: up to 75% of the time
• Typical Work Days/Hours: Monday through Friday; 8:30am – 5:00 pm (CST)

Driving

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. Eligible mileage includes:

• Travel from your home to your first work location of the day.
• Travel between client or assignment locations during the workday.
• 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 us

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 atHumana.comand atCenterWell.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.