RN Care Manager

Join Our Caring Community

Humana/iCare is seeking an RN Care Manager to join the team in the Family Care Partnership (FCP) program to provide services to members in our newly expanded service area to include the following counties: Racine, Kenosha, Waukesha, Washington, Ozaukee, Walworth and Sheboygan. Reporting to the Manager of Care Management, you will provide case management and support to adults in the community, assuring quality services are provided that are cost effective, all while monitoring the health and safety of your members. You will work as part of an Interdisciplinary Team (IDT) setting to help manage members that are enrolled in the Family Care Partnership program. You will conduct home and community visits to members to complete the nursing assessment and assures members have appropriate care and access to services.

Essential duties:

• Complete the nursing portion of the comprehensive assessment and provide input to the members care accordingly.
• Monitor wellness and health promotion activities based on the member's assessment and identified outcomes.
• Re-evaluate the member's health and wellness at appropriate intervals to manage ongoing health issues, assess the member's response to interventions, or when a medical complaint or event affecting the member's health occurs.
• Perform routine health monitoring activities, based on the member's need.
• Build constructive working relationships with members, their family members, and appropriate outside agency staff.
• In crisis situations, provides appropriate assessment of psychiatric, behavioral or medical problems and implements interventions in conjunction with other staff to take appropriate measures to ensure the safety of members.
• Evaluate members' ability to safely manage, either by themselves or through use of supports, their medication, medical care interventions and treatments, equipment, and access to health care services.
• Provide or arrange for services, supports or medical care that best meet the member's identified needs, and monitor the effectiveness of these interventions.
• Assists with program, policy, and procedure development and assists with input for the QI/QA program.

Required Qualifications:

• Must be a Registered Nurse, licensed in the State of Wisconsin.
• Two (2) years of related health care experience.
• Must be able to travel to any location within the following counties: Racine, Kenosha, Waukesha, Washington, Ozaukee, Walworth, Sheboygan.

Preferred Qualifications:

• Bachelor of Science degree in Nursing (BSN).
• Previous home health, managed care or case management experience.
• Previous experience working with persons with physical, intellectual/developmental disabilities, or older adults in a health care setting.
• Case Manager Certification.
• General knowledge of Medicaid and Medicare benefits.

Additional Information:

• Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.
• Travel: Up to 50% throughout the following counties: Racine, Kenosha, Waukesha, Washington, Ozaukee, Walworth, Sheboygan.
• Typical Work Days/Hours: Monday – Friday, 8:30 am – 5:00 pm Central Standard Time (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.

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.

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: $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

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, 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.