Telephonic Case Manager

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

📋 Description

• Perform initial and annual evaluations of members' medical, behavioral, and social requirements.

• Organize assessment data to create and execute care plans.

• Establish collaborative relationships with physicians, social service providers, and others involved in the Care Coordination process.

• Aid in resolving issues related to members and providers, acting as a member advocate.

• Provide guidance regarding the member grievance process.

• Review, oversee, and revise care plans as necessary.

• Educate members and providers on benefits, service providers, access protocols, and proper utilization of medical services.

• Offer referrals to community resources and social services.

• Record member information, interactions, care, and services rendered.

• Monitor members' readiness to engage in treatment plans and collaborate with staff, members, and providers to create solutions.

• Conduct follow-up calls post-hospitalization and after emergency room visits.

• Participate in or lead interdisciplinary care team meetings.

• Educate members regarding preventive health guidelines and programs.

• Report directly to the Manager of Care Management Support.

• Occasionally travel to Humana offices for training or meetings.

⛳️ Requirements

• Bachelor’s degree in a health and human services discipline.

• A minimum of 2 years of experience in case management.

• Must reside in the State of Wisconsin.

• A minimum download speed of 25 Mbps is required.

• A minimum upload speed of 10 Mbps is necessary.

• Work from a designated area free from ongoing interruptions to safeguard member PHI/HIPAA information.

• Availability from Monday to Friday, between 8:00 am and 5:00 pm CST.

• Bilingual skills are preferred.

• Prior experience with Medicare & Medicaid recipients is preferred.

• Background in Behavioral Health is preferred.

• Previous experience with electronic case note documentation is favored.

• Familiarity with community health and social service agencies and additional community resources is preferred.

🏝️ 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.

• Work from home options.

• Competitive benefits that support overall well-being.