RN Care Manager

Humana Inc; Madison (WI); Hybrid; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Paid time off

Job summary

Humana Inc. is seeking a RN Care Manager in Wisconsin to coordinate care for members in the Wisconsin Family Care Program. The role involves health assessments, education, documentation, and collaboration with healthcare providers.

You will work remotely from home with travel about 40% to visit members and perform in-person visits. The position requires an Associate degree in nursing and an active WI RN license.

Qualifications

• Associate degree in nursing is required.
• Licensed RN in Wisconsin in good standing.
• Reside within 45 minutes or less of the assigned coverage area.

Responsibilities

• Assess members and develop a comprehensive Member Care Plan (MCP).
• Conduct regular health assessments.
• Coordinate with acute and primary care providers.
• Educate members on disease processes, nutrition, exercise, and lifestyle changes.
• Document in member files within required DHS timeframes.
• Travel to in-person visits and remote member contacts (approx. 40% travel).
• Use D365 to assign tasks and update records.

Skills

Care coordination

Patient education

Education

Associate degree in nursing

Registered Nurse license in Wisconsin

Tools

D365

Job description

Become a part of our caring community 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.

You will:

• 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.
• Work remotely from your home and travel approximately 40% of the time to visit your members.
• Use your skills to make an impact.

Required Qualifications

• Associate degree in nursing.
• Licensed Registered Nurse in the state of Wisconsin (in good standing).

Preferred Qualifications

• 3 years Care Management experience.
• Reside within 45 mins or less of the assigned coverage area.
• Previous Care Management experience.

Location: Dane County and Columbia County surrounding areas, WI

Travel: Up to 40%

Typical Workdays/Hours: Monday through Friday, 8:00 am – 4:30 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.

Pay range: $71,100 - $97,800 per year.

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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 benefits.
• Dental benefits.
• 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.
• Many other opportunities.

About us

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.