Humana

RN Care Manager- WI Rapids

Posted on

March 7, 2025

Job Type

Full-Time

Role Type

Care Management

License

RN

State License

Wisconsin

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Company Description

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.

Job Description

Say goodbye to nights, weekends and on call and hello to more time with your family!!! Humana is seeking an RN Care Manager to join the Inclusa team to serve members in the Wisconsin Family Care (FC) program in Dane County. This is a Monday through Friday role with an 8-4:30pm schedule. As a RN Care Manager, you will be responsible for partnering with your fellow colleagues to provide top quality coordination of care to our members. They are looking to you in providing assistance when it comes to living their daily lives. The RN is responsible for facilitating the coordination, communication, negotiation, and collaboration of streamlined healthcare delivery processes on behalf of the member.

Requirements

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: Wisconsin Rapids, Wisconsin and surrounding area. Travel: up to 40% throughout Wisconsin Rapids, 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. 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.

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Responsibilities

Partner with a social services care manager (also referred to as a Community Resource Coordinator/Care Coach) and collaborate on an ongoing basis regarding the member and their plan. Perform face-to-face health-related assessments for members upon enrollment and at least every six (6) months thereafter in the member’s setting. Coordinate, perform, and track quarterly face-to-face visits and monthly phone contacts. Participate in the development and ongoing review and coordination of the member’s plan of care. Take the lead on all health issues for the member. Contact and coordinate with acute and primary care providers. Identify and coordinate clinical and functional supports needed for the member’s health and safety. Educate on and promote prevention and wellness and mitigate risk when assessed. Document activity and complete paperwork as required. Traveling will be required and eligible for mileage reimbursement.

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