RN Care Manager

About the role

As a RN Care Manager, you will enjoy a true work-life balance with no night or weekend shifts. Reporting to the Manager of Care Coaching, you will support members enrolled in the Wisconsin Family Care Program providing essential care coordination, support, and education. You will make a difference in the lives of those you serve and within your own community.

Responsibilities

• Assess members, focusing on health and safety needs, to develop a comprehensive Member Care Plan (MCP)
• Conduct regular health assessments
• Coordinate with acute and primary care providers
• Educate members on disease processes and related risks, nutrition, exercise and lifestyle modifications to support informed decision-making while respecting each person's autonomy
• Document in member files within required DHS contract timeframes
• Participate in member monthly phone contacts and travel to attend in person visits in members setting
• Complete record reviews for reassigned members, including identifying areas where record remediation is needed
• Provide support regarding record review and remediation. Support the team as they adapt to and navigate this change
• Complete documentation for remediation
• Ensure that newly assigned RNs and their Care Coach partners are informed of any missing or needed follow-up, including assignment of tasks in the D365 system
• Accept additional complex member assignments
• Provide additional support with new member assignments

Required Qualifications

• Associate degree in nursing
• Licensed Registered Nurse in the state of Wisconsin (in good standing)

Preferred Qualifications

• 3 years Care Management experience
• Reside within 45 mins or less of the assigned coverage area
• Previous Care Management experience

Schedule

• Typical Workdays/Hours: Monday through Friday, 8:00 am – 4:30 pm CST
• Work remotely from your home and travel approximately 40% of the time to visit your members
• While this is a remote position, occasional travel to Humana's offices for training or meetings may be required

Pay

• $71,100 - $97,800 per year
• This job is eligible for a bonus incentive plan based upon company and/or individual performance

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance

Additional Information

• Location: Dane County and Columbia County surrounding areas, WI
• Travel: Up to 40%. 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, and travel from your final work location back to your home.
• Driving: This role requires a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
• TB Screening: This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected, you will be required to be screened for TB.
• Work at Home Requirements: 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. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Scheduled Weekly Hours: 40