FCP Case Manager

đź•’ vor 3 Tagen

🧀 Wisconsin – Remote

infoinfo

đź’µ $53.700 - $72.600 / Jahr

⏰ Vollzeit

🟢 Junior

đź‘” Manager

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Humana

Humana

10.000+ Mitarbeiter

GegrĂĽndet 1961

🏥 Gesundheitswesen

🛡️ Versicherung

⚕️ Krankenversicherung

Healthcare • Insurance • Healthcare Insurance

Humana ist ein Gesundheitsunternehmen, das sich zum Ziel gesetzt hat, die Gesundheit von Individuen, Gemeinschaften und dem Gesundheitssystem insgesamt positiv zu beeinflussen. Mit einem klaren Fokus darauf, Gesundheit an erste Stelle zu setzen, bedient Humana eine vielfältige Zielgruppe, darunter Senioren und das Militär, und bietet Medicare Advantage HMO-, PPO- und PFFS-Pläne an. Humana engagiert sich für eine Kultur der Zugehörigkeit und des gegenseitigen Respekts und bietet wettbewerbsfähige und flexible Vorteile, um die finanzielle Sicherheit seiner Mitarbeiter und deren Familien zu gewährleisten. Das Unternehmen ist stolz darauf, einen inklusiven Arbeitsplatz zu schaffen, an dem jeder die Möglichkeit hat, erfolgreich zu sein.

Beschreibung

• Conduct psychosocial and comprehensive assessments • Use Resource Allocation Decision-making methodology to identify member outcomes and strategies • Identify community resources and cost-effective services or equipment • Coordinate and monitor services and resources • Conduct reassessments and update care plans • Monitor members' health, safety, and progress • Assist with complaints, grievances, and advocacy services • Document member information, contacts, care, and services according to policy and audit requirements • Build working relationships with members, families, and outside agency staff • Coordinate care with physicians and medical professionals • Assist with resolving issues between members and providers • Educate members and providers about benefits, service providers, protocols, and medical services • Provide community resource and social service referrals • Monitor members' engagement in treatment and develop alternatives or solutions with staff and providers

🎯 Anforderungen

• Wisconsin-certified Social Worker with a minimum of one (1) year working with at least one Family Care target group population; OR • 4-year bachelor's degree or more advanced degree in Human Services and a minimum of one (1) year of experience working with at least one Family Care target population; OR • 4-year bachelor's degree or more advanced degree in another field and a minimum of three (3) years of experience working with at least one Family Care population • Family Care target populations: Frail Elders, Physically Disabled, or Intellectually/Developmentally Disabled • Knowledge of community resources and long-term care options • Ability to travel throughout Milwaukee, Walworth, Racine/Kenosha, Waukesha, Washington, Ozaukee, and Sheboygan Counties to conduct in-home assessments • Valid state driver's license • Proof of personal vehicle liability insurance with at least 100/300/100 limits • Required TB screening for selected candidates • Preferred: Wisconsin Social Work certification/licensure or eligibility for certification and licensure • Preferred: Previous managed care experience • Preferred: General knowledge of Medicaid and Medicare benefits • Home internet with at least 25 Mbps download and 10 Mbps upload • Ability to work from a dedicated space protecting member PHI/HIPAA information

🏖️ Vorteile

• 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 • Occasional travel to Humana offices for training or meetings

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