RN Care Manager

Humana/iCare is seeking an RN Care Manager to join the team in the Family Care Partnership (FCP) program to provide services to members in our newly expanded service area to include the following Counties: Racine, Kenosha, Waukesha, Washington, Ozaukee, Walworth and Sheboygan.

Reporting to the Manager of Care Management, you will provide case management and support to adults in the community, assuring quality services are provided that are cost effective, all while monitoring the health and safety of your members. You will work as part of an Interdisciplinary Team (IDT) setting to help manage members that are enrolled in the Family Care Partnership program. You will conduct home and community visits to members to complete the nursing assessment and assures members have appropriate care and access to services.

Essential duties

• Complete the nursing portion of the comprehensive assessment and provide input to the members care accordingly.
• Monitor wellness and health promotion activities based on the member's assessment and identified outcomes.
• Re-evaluate the member's health and wellness at appropriate intervals to manage ongoing health issues, assess the member's response to interventions, or when a medical complaint or event affecting the member's health occurs.
• Perform routine health monitoring activities, based on the member's need.
• Build constructive working relationships with members, their family members, and appropriate outside agency staff.
• In crisis situations, provides appropriate assessment of psychiatric, behavioral or medical problems and implements interventions in conjunction with other staff to take appropriate measures to ensure the safety of members.
• Evaluate members' ability to safely manage, either by themselves or through use of supports, their medication, medical care interventions and treatments, equipment, and access to health care services.
• Provide or arrange for services, supports or medical care that best meet the member's identified needs, and monitor the effectiveness of these interventions.
• Assists with program, policy, and procedure development and assists with input for the QI/QA program.

Required Qualifications

• Must be a Registered Nurse, licensed in the State of Wisconsin.
• Two (2) years of related health care experience.
• Must be able to travel to any location within the following counties:RacineKenoshaWaukeshaWashingtonOzaukeeWalworthSheboygan

Preferred Qualifications

• Bachelor of Science degree in Nursing (BSN).
• Previous home health, managed care or case management experience.
• Previous experience working with persons with physical, intellectual/developmental disabilities, or older adults in a health care setting.
• Case Manager Certification.
• General knowledge of Medicaid and Medicare benefits.

Additional Information

• Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.
• Travel: up to 50% throughout the following counties: Racine/ Kenosha/Waukesha/Washington/Ozaukee/Walworth/Sheboygan
• Typical Work Days/Hours: Monday – Friday, 8:30 am – 5:00 pm Central Standard Time (CST).

Driving

This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

TB

This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

$71,100 - $97,800 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.