Telephonic Case Manager

🔥 0 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $53.7k - $72.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Conduct initial and annual assessments of members' medical, behavioral, and social needs • Coordinate assessment information to develop and implement care plans • Build working relationships with physicians, social service providers, and others in the Care Coordination process • Assist with problem resolution involving members and providers as a member advocate • Provide information for the member grievance process • Review, monitor, and update care plans • Educate members and providers about benefits, service providers, access protocols, and appropriate use of medical services • Provide referrals to community resources and social services • Document member information, contacts, care, and services provided • Monitor members' willingness to participate in treatment regimens and develop solutions with staff, members, and providers • Conduct follow-up calls after hospitalizations and emergency room visits • Participate in or facilitate interdisciplinary care team meetings • Educate members on 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 health and human services field • 2 or more years of case management experience • Must reside within the State of WI • Minimum download speed of 25 Mbps • Minimum upload speed of 10 Mbps • Work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information • Monday–Friday availability, 8:00 am–5:00 pm CST • Bilingual preferred • Prior experience with Medicare & Medicaid recipients preferred • Prior Behavioral Health experience preferred • Previous experience with electronic case note documentation preferred • Knowledge of community health and social service agencies and additional community resources 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 • Competitive benefits supporting whole-person well-being

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