Case Manager - Sparta, WI

$53,700 - $72,600 / year

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

Join Humana as a Case Manager within the Inclusa/Humana team, where you will serve members in the Wisconsin Family Care (FC) program. Reporting to the Manager of Care Coaching, you will provide comprehensive case management services to frail elders and adults with intellectual, developmental, or physical disabilities.

Main responsibilities:

· Assess members health and safety needs to identify their strengths, interests, and preferences to develop a comprehensive Member Care Plan (MCP).

· Coordinate with a Field Care Nurse to provide services that address members' health and safety needs, ensuring the team provides support in the least restrictive environment following the MCP.

· Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence.

· Conduct quarterly in-person visits and maintain monthly contact with members by phone.

· Arrange support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs.

· Ensure cost-effective service delivery.

· Evaluate risk factors and provide education to members.

· Maintain accurate documentation including case notes, service authorizations, and updates to the MCP.

Use your skills to make an impact

· A Bachelor's degree in human services or a related field is required, with at least 1 year of experience serving frail elders or adults with intellectual, developmental, or physical disabilities. Alternatively, a Bachelor's degree in another field with at least 3 years of such experience is also acceptable.

· Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits

Preferred Qualifications

· Case Management experience

· Experience with electronic case note documentation

· Knowledge of community health and social service agencies and additional community resources

Additional Information

· Work Location: Sparta, WI (Monroe County)

· Travel: up to 40%

· Typical Workdays/Hours: Monday – Friday, 8:00 am – 4:30 pm 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.

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.

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.

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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.

$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 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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Excellent interpersonal skills, effective communication skills, creative problem solving and excellent critical thinking and leadership EDUCATION REQUIREMENTS-See Attached for Additional Detail Licensure: New York State License with current registration as a registered nurse. State Certification: Certified by the New York State Department of Education as a Nurse Practitioner with current registration as follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR is certified as a Nurse Practitioner by a national association via examination. b. Has completed a pharmacy component of not less than the required semester hours or the equivalent AND has been instructed in New York State and Federal Laws relating to prescriptions and recordkeeping (3-hour course). c. Has a Collaborative Practice Agreement with a physician and designated protocols if less than 3600 hours experience as a practicing Nurse Practitioner. 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We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. Compensation The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $84.5895 - $84.5895 Hourly. Actual salaries depend on a variety of factors, including experience, education, and operational need. 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