FCP Case Manager

This is a fully remote position, open to applicants in Wisconsin.

📋 Description

• Perform psychosocial and thorough assessments.

• Employ Resource Allocation Decision-making methodology to determine member outcomes and strategies.

• Identify community resources along with cost-effective services or equipment.

• Coordinate and oversee services and resources.

• Conduct reassessments and revise care plans as necessary.

• Monitor members' health, safety, and overall progress.

• Assist with complaints, grievances, and advocacy services.

• Document member details, contacts, care, and services in accordance with policy and audit requirements.

• Establish professional relationships with members, families, and staff from outside agencies.

• Collaborate with physicians and medical professionals to coordinate care.

• Help resolve issues that arise between members and providers.

• Educate members and providers on benefits, service providers, protocols, and medical services.

• Provide referrals to community resources and social services.

• Monitor members' participation in treatment and develop alternative solutions in collaboration with staff and providers.

⛳️ Requirements

• Wisconsin-certified Social Worker with a minimum of one (1) year of experience working with at least one Family Care target group population; OR

• A 4-year bachelor's degree or a higher degree in Human Services along with at least one (1) year of experience working with one Family Care target population; OR

• A 4-year bachelor's degree or a higher degree in another field, coupled with a minimum of three (3) years of experience working with at least one Family Care population.

• Family Care target populations include: Frail Elders, Physically Disabled, or Intellectually/Developmentally Disabled.

• Familiarity with community resources and long-term care options.

• Ability to travel throughout Milwaukee, Walworth, Racine/Kenosha, Waukesha, Washington, Ozaukee, and Sheboygan Counties for in-home assessments.

• Valid state driver's license.

• Proof of personal vehicle liability insurance with minimum limits of 100/300/100.

• Required TB screening for selected candidates.

• Preferred: Wisconsin Social Work certification/licensure or eligibility for certification and licensure.

• Preferred: Previous experience in managed care.

• Preferred: General understanding of Medicaid and Medicare benefits.

• Home internet connection with a minimum of 25 Mbps download and 10 Mbps upload speed.

• Ability to work from a designated space that protects member PHI/HIPAA information.

🏝️ Benefits

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Mileage reimbursement for work-related travel.

• Remote work options.

• Occasional travel to Humana offices for training or meetings.