Telephonic Case Manager

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

Job summary

Humana is seeking a Telephonic Case Manager to work from home, remotely supporting members by phone. You will conduct assessments, develop and update care plans, and coordinate with providers to ensure timely, person-centered care.

Strong communication and empathy are essential to advocate for members and improve health outcomes. Responsibilities include educating members on benefits and resources, documenting interactions, and participating in interdisciplinary team meetings.

Qualifications

• Bachelor's degree in health and human services required.
• 2+ years of case management experience required.
• Must reside within Wisconsin (WI).

Responsibilities

• Conduct initial and annual assessments of members' medical, behavioral and social needs.
• Develop care plans addressing identified needs with member and providers.
• Coordinate with physicians and social service providers in care coordination.
• Review and update care plans as indicated.
• Educate members on benefits, services, and access protocols; provide referrals to community resources.

Skills

Case management

Bilingual

Medicare & Medicaid knowledge

Behavioral Health experience

Community resources knowledge

Education

Bachelor's degree in health and human services

Tools

Electronic health records (EHR)

Electronic case notes

Job description

Become a part of our caring community

Join our team at Humana as a Telephonic Case Manager! You'll work from home, connecting with members over the phone, support their care journeys, and help affect their health and well-being. You'll collaborate with a caring team, build your skills, and bring your empathy to every conversation. You will report directly to the Manager of Care Management Support, who will support your success.

Main Responsibilities

• Conduct initial and annual assessments of members' medical, behavioral and social needs.
• Coordinates and organizes information from members' assessment to develop a care plan that addresses their needs and assures implemented interventions are collaborated with members and their providers/supports.
• Builds constructive working relationships with physicians, social service providers and others by involving them in the Care Coordination process and assists in problem resolution involving members and providers as a member advocate including information for the member grievance process.
• Review, monitors and updates care plans as indicated.
• Provide information to members and providers regarding benefits, service providers and access protocols and educate members on appropriate use of medical services. Provide referrals for community resources and social services.
• Document member information and contacts made regarding member's care and services provided.
• Monitor member's willingness to participate in treatment regimes, and problem solves with staff, members and providers, alternatives or solutions to their needs.
• Conduct follow up calls post hospitalization and emergency room visits according to policy.
• Contribute to interdisciplinary i Care team meetings as either a participant or a facilitator.
• Educate members on preventive health guidelines and programs.

Use your skills to make an impact

Required Qualifications

• Bachelor's degree in health and human services field
• 2 or more years of case management experience
• Must reside within the State of WI

Preferred Qualifications

• Bilingual
• Prior experience with Medicare & Medicaid recipients
• Prior Behavioral Health experience
• Previous experience with electronic case note documentation
• Knowledge of community health and social service agencies and additional community resources

Additional Information

• Typical Workdays/Hours: Monday - Friday, 8:00 am - 5:00pm CST
• Work from home- on occasion may be required to travel to one of our offices

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 at Humana.com and at CenterWell.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, sexu