Registered Nurse Care Manager

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

📋 Description

• Evaluate the health and safety requirements of members and create detailed Member Care Plans.

• Perform regular health evaluations.

• Collaborate with acute and primary care providers.

• Provide education to members regarding disease processes, associated risks, nutrition, exercise, and lifestyle changes.

• Maintain documentation in member files within the stipulated DHS contract timelines.

• Engage in monthly phone interactions with members and travel for in-person visits.

• Operate remotely from home while traveling approximately 40% of the time to meet members.

• Conduct record reviews for reassigned members and pinpoint areas needing remediation.

• Finalize documentation for clear record remediation.

• Notify newly assigned RNs and Care Coach partners about missed or necessary follow-ups.

• Allocate tasks in the D365 system as required.

• Offer assistance regarding record review and remediation processes.

• Provide support to the team during procedural changes.

• Accept additional complex member cases as needed.

• Assist with new member assignments.

• Alert Managers to significant risks or concerns discovered during record reviews.

⛳️ Requirements

• Associate degree in nursing.

• Active Registered Nurse license in Wisconsin (in good standing).

• Preferred: At least 1 year of experience in Care Management.

• Preferred: Reside within 45 minutes or less of the designated coverage area.

• Previous experience in Care Management is preferred.

• Valid state driver's license.

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

• Completion of TB screening is mandatory if selected.

• Self-provided internet connection with a minimum of 25 Mbps download and 10 Mbps upload speed.

• Designated workspace free from interruptions to protect member PHI / HIPAA information.

🏝️ Benefits

• No night or weekend shifts.

• Mileage reimbursement for work-related travel.

• Comprehensive medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Bonus incentive program.

• Remote work from home opportunities.

• Occasional travel to Humana offices for training or meetings.