RN Care Manager Lead

Humana Inc; West Bend (WI); On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Bonus program

Job summary

Humana Inc. is seeking an RN Care Manager Lead within the Family Care Partnership (FCP) program. You will mentor the FCP team, guide the Interdisciplinary Team, and coordinate care to address complex medical, psychiatric, and social needs in a member-centric approach.

Reporting to the Manager of Care Management, you will lead nursing and care coordination activities, ensure contractual compliance, and support staff development while serving the community in SE WI and surrounding areas.

Qualifications

• Registered Nurse, licensed in the State of Wisconsin and in good standing.
• Travel approximately 20% of your time throughout the Kenosha, Racine, Milwaukee, Waukesha, Walworth, Washington, and Sheboygan.
• 2 years of Managed Care experience.

Responsibilities

• Mentor care managers and nurses in the Family Care Partnership model and provide staff education.
• Conduct nursing assessment and reassessment as part of initial and ongoing care planning.
• Coordinate and monitor services to meet member outcomes through the IDT and community resources.
• Assist members and their families in identifying needs and accessing medical, social, rehabilitation, vocational, educational and other services.

Skills

RN license WI

Travel readiness

Managed Care experience

Job description

Become a part of our caring community Humana/iCare is looking for an RN Care Manager Lead to join the growing team in the Family Care Partnership (FCP) program. Reporting to the Manager of Care Management, you will provide lead care management services through the FCP program. You will also provide support to the FCP Nurses and Care Coaches in a mentoring capacity. You will work with the Interdisciplinary Team (IDT) to guide and support them in serving FCP members to provide health care, behavioral health, and social services to meet identified complex and episodic medical, psychiatric, and social needs of the population. Share your talents and develop your leadership skills all while doing your part to improve the lives of others.

Responsibilities:

Mentoring

• Arrange for shadowing experiences in the field and application for new care managers and nurses during their orientation period.
• Communicate with the appropriate manager regarding an employee's participation and progress in mentoring activities.
• Provide education and coaching on the CM and RN role and teamwork within the Interdisciplinary Team including specific responsibilities as it relates to contractual compliance per discipline.
• Help provide ongoing training for staff to develop proficiency and advanced knowledge in the Family Care model and other supplementary best practices following the Employee Development Plan and other projects that develop.
• Collaborate with Leadership to identify external trainings needed to support/enhance best practices.
• Coordinate and implement external trainings needed and ensure effectiveness of training.

Assessment and Care Coordination

• Conduct nursing assessment as part of the initial comprehensive assessment and reassessment process.
• Use the Resource Allocation Decision making methodology (RAD)
• Coordinate and monitor services and resources implemented to meet members' identified outcomes and members progress toward meeting those outcomes.
• Conduct periodic RN reassessment and updates of the member's care plan and monitor the member's health and safety.
• Assist members and their families to identify other service needs and gain access to medical, social, rehabilitation, vocational, educational and other services identified to achieve outcomes.
• Assist members or members' representatives in filing complaints, grievances and obtaining advocacy services.

Required Qualifications

• Registered Nurse, licensed in the State of Wisconsin and in good standing.
• Travel approximately 20% of your time throughout the Kenosha, Racine, Milwaukee, Waukesha, Walworth, Washington, and Sheboygan.
• 2 years of Managed Care experience.

Preferred Qualifications

• Bi-lingual skills- English & Spanish
• Training or mentoring experience
• Knowledge of community health and social service agencies and additional community resources

Additional Information

Workstyle: Field. Field workstyle is defined as associates performing their core duties at one or more non-Humana/iCare locations.
Work Location: must reside within a commutable distance within the Family Care Partnership service area - SE WI. Travel: up to 20% travel throughout FCP service area Typical Workdays/Hours: Monday – Friday; 8:30am – 5:00 pm Central Standard Time (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: 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.

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.

$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

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.