RN Care Manager

Humana Inc; Milwaukee, Northern (WI, KY); Hybrid; USD 71,000 - 98,000; Full time

Benefits offered by this job

Mileage reimbursement

TB screening

Job summary

Humana Inc. seeks a RN Care Manager to support Wisconsin Family Care members with care coordination, education, and coaching, while offering a true work-life balance with no night or weekend shifts. You will assess members, develop an MCP, coordinate with providers, educate on diseases and lifestyle changes, and document in DHS timelines.

Expect travel up to 40% and remote work from home. The role requires an RN with an associate degree and Wisconsin licensure; 3+ years of care management

Qualifications

• Associate degree in nursing.
• Licensed Registered Nurse in Wisconsin (in good standing).
• 3+ years Care Management experience.
• Reside within 45 mins or less of the assigned coverage area.
• Previous Care Management experience.

Responsibilities

• Assess members to 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 modifications to support informed decision-making while respecting autonomy.
• Document in member files within required DHS contract timeframes.
• Travel to attend in-person visits and complete member monthly phone contacts (~40% travel).
• Complete record reviews for reassigned members and remediation.
• Provide support with record review/remediation and new member assignments.

Skills

Care Management experience

Education

Associate degree in nursing

Job description

Job Overview

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

Additional Information

Location: Milwaukee, 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

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, certifications, etc. $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, 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

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.

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.