RN Care Manager - Marshfield, WI

apartment Humana location_onMarshfield, WI, US

$71,100 - $97,800 / YEAR

Become a part of our caring community and help us put health first

Enjoy a rewarding career with a true work/life balance—no nights or weekends, giving you more time for what matters most. Humana is currently seeking an RN Case Manager to join our team, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana.

Key responsibilities:

Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan.
Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care plans that support their continued health and safety.
Contribute to the creation, continuous evaluation, and coordination of the member’s plan of care, including coordinating with outside providers to provide support with medication administration, assistance with home care, skilled nursing visits, and related services to ensure comprehensive care.
Contact and coordinate with acute and primary care providers.
Promote health and wellness through patient education on disease prevention, nutrition, exercise and lifestyle modifications.
Provide members with education and information about disease processes and related risks, supporting informed decision-making while respecting each individual's autonomy.
Daily documentation in member files within required DHS contract timeframes.
Participate in member monthly phone contacts and attend in person visits in members setting.
Traveling will be required and eligible for mileage reimbursement.

Use your skills to make an impact

Required Qualifications

Associate degree in nursing.
Must be a Registered Nurse, licensed in the state of Wisconsin.

Preferred Qualifications

Bachelor’s degree in nursing.
One (1)+ years of experience with Family Care target group: frail elders and adults with intellectual, developmental, or physical disabilities.
Care Management experience.

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.
Work Location: Marshfield, Wisconsin and surrounding area.
Travel: up to 40% throughout Marshfield, WI and surrounding area.
Typical Work Days/Hours: Monday through Friday, 8:00 am – 4:30 pm CST.

WAH Internet Statement

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.
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 business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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.

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.

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

SSN Alert

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Scheduled Weekly Hours

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About Inclusa: 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.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large.

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.

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Healthfirst is New York City’s largest not-for-profit health insurer, dedicated to improving health through community-driven, value-based care. For over 30 years, we have led the shift from volume to value by focusing on better outcomes, preventative care, and cost efficiency. Recognized by Forbes as a Dream Employer of 2025, Healthfirst is committed to fostering a culture of innovation, creativity and belonging. As a UAS Nurse Assessor, you will help ensure our members receive the care and services they need to lead healthier, more independent lives. This role is perfect for RNs who are passionate about making a positive impact in the lives of patients//families and appreciates a job with flexibility and manageable caseloads. Whether you’re an experienced nurse or a new graduate eager to start your career, you’ll have the opportunity to grow in a supportive environment. Enjoy the benefit of working in the field conducting in-person assessments throughout Brooklyn—close to great public transportation, shopping centers, and some of NYC’s most vibrant neighborhoods. Duties and Responsibilities: · Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. As needed, conducts assessments in settings other than home as needed, e.g. skilled nursing facilities or virtually · Navigates multiple technology//digital platforms such as UAS software, electronic medical records, TruCare, etc., to conduct and document comprehensive assessments accurately and efficiently · Completes assessment of service needs per CMT and member's family//caregiver’s request to determine service needs or any necessary adjustments · Reviews previous nursing assessments//medical notes to determine necessary adjustments//updates in Care Plan and//or to assist with nursing home admission · Conducts in-person Care Management visits in support of person-centered service planning · Liaisons between the member and the CMT; assesses home environment and psychosocial status · Provides feedback to home care agencies and CMT regarding home care issues and contract nurses and aides performance · Provides grass roots, community-based training for frail population care including self-care techniques and prevention strategies · Ensures (prospective) members and significant others//responsible parties understand and are in agreement with enrollment in a managed long-term care plan · Additional duties as assigned Minimum Qualifications: · New York State RN license · Ability to travel around downstate New York which includes the 5 boroughs, Long Island, Rockland, and Westchester. · Prior work experience requiring technological proficiency including the ability to navigate multiple technology platforms and modalities · Prior work experience requiring intermediate Microsoft Word, Excel, and Outlook skills · Prior work experience requiring time management, critical//creative thinking, communication, and problem-solving skills · For PEDS positions only: 1 year of pediatric clinical field experience and//or experience with families and child serving systems, including child welfare and//or medically fragile//developmentally disabled populations Preferred Qualifications: · Work experience using electronic patient health information (PHI) database usage especially UAS · Previous field-based experience assessing, planning, and evaluating member's care by making home or facility visits for intake//reassessments or start of care (SOC) Community Home Health Agency (CHHA) visits · Work experience preferred in one or more of the following areas, geriatrics, home care, discharge planning, case management, and//or medical surgical nursing · Knowledge of health insurance, Medicaid, Medicare and MLTCP · Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services for frail population as well as negotiate initial service plans so that members and families are in agreement · Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese · Demonstrated ability handling heavy caseloads · NY state driver’s license Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $102,000 - $120,000 All Other Locations (within approved locations): $71,600 - $106,505 $10,000 Sign-On Bonus As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.