Remote Case Manager - Community Care Advocate

Humana; United States; Remote; USD 54,000 - 73,000; Full time

Benefits offered by this job

Mileage reimbursement

Job summary

Humana is seeking a Case Manager to serve Wisconsin Family Care members under the Inclusa/Humana team. This is primarily a work-from-home role with periodic visits to Vernon County for required member visits.

You will assess needs, coordinate with a Field Care Nurse, arrange supportive services, and maintain MCP documentation, while ensuring cost-effective service delivery and compliance with HIPAA/PHI protections.

Qualifications

• Bachelor’s degree in human services or related field with at least 1 year of experience serving frail elders or adults with IDD.
• Alternatively, a Bachelor’s degree in another field with at least 3 years of such experience.
• Valid state driver’s license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

Responsibilities

• Assess members' health and safety needs to develop a comprehensive Member Care Plan (MCP).
• Coordinate with a Field Care Nurse to address health and safety needs within the MCP.
• Conduct face-to-face social assessments upon enrollment and at least every six months.
• Conduct quarterly in-person visits and maintain monthly contact with members by phone.
• Arrange support services including social integration, community resources, housing, and non-medical needs.
• Ensure cost-effective service delivery and evaluate risk factors.
• Maintain accurate documentation including case notes, service authorizations, and MCP updates.

Skills

Case management

Electronic case notes

Community resources knowledge

Education

Bachelor’s degree in human services or related field

Bachelor’s degree in another field with 3+ years relevant experience

Job description

Humana is seeking a Case Manager to serve Wisconsin Family Care members under the Inclusa/Humana team. This is primarily a work-from-home role with periodic visits to Vernon County for required member visits.

You will assess needs, coordinate with a Field Care Nurse, arrange supportive services, and maintain MCP documentation, while ensuring cost-effective service delivery and compliance with HIPAA/PHI protections.