Case Manager

Join the Humana team in this exciting role as a Case Manager. Reporting to the Manager of Care Management Support, you will provide care coordination, support, and education to members enrolled Medicaid, BadgerCare, SSI. You will work from home but will also be required to visit your members in their home or community setting throughout the southeastern Wisconsin area (approximately 50% travel). Responsibilities Conduct comprehensive Medicaid‑required psychosocial and functional assessments as part of the care management process to identify member needs, risks, strengths, and barriers affecting health and independence. Develop, implement, coordinate, and monitor individualized, person‑centered care plans following Medicaid program requirements, ensuring services and supports align with member‑identified goals and outcomes. Perform ongoing reassessments and care plan updates at required intervals and as member needs change, monitoring health status, safety, service effectiveness, and progress toward desired outcomes. Conduct required face‑to‑face visits with members in their homes or community settings to assess needs, evaluate service delivery, provide education, and support member engagement in care. Coordinate and monitor Medicaid‑covered services, and community‑based resources to ensure access, continuity of care, and avoidance of service gaps. Document assessments, face‑to‑face visits, care plans, member interactions, and service coordination activities following Medicaid, contractual, and organizational documentation standards. Educate members on preventive health measures, wellness strategies, and care adherence to support improved health outcomes and compliance with Pay for Performance (P4P) quality measures. Build collaborative relationships with members, families, caregivers, providers, and community agencies to promote engagement, and care coordination. Collaborate with physicians, interdisciplinary care teams, and other healthcare professionals to coordinate and integrate medical, behavioral, and social services. Educate members and providers regarding Medicaid benefits, covered services, provider roles, and appropriate use of healthcare services; refer members to community resources and social services. Required Qualifications Bachelor's degree in health and human services field. 2 or more years of experience in case management. Must have a private room with a locked door that can be used as a home office to ensure privacy while you work. Preferred Qualifications License in health and human services field (CSW, LPC, LPC‑IT, OT‑A). Bilingual in English/Spanish. Behavioral Health experience. Experience working in a managed care organization. Prior experience with Medicare & Medicaid recipients. Additional Information Location: must reside in southeastern WI area. Workstyle: Field Travel: Up to 50% throughout southeastern WI. Typical Workdays/Hours: Monday through Friday, 8:30 am – 5:00 pm 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 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. WAH Internet Statement To Ensure Home Or Hybrid Home/Office Employees', 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. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi‑weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. HireVue As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule. 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 $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, volunteer time off, 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 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. #J-18808-Ljbffr