RN Care Manager- Variable Janesville, WI at Humana
About the position
Humana is seeking an RN Care Manager- Variable (Health & Wellness Coordinator) to join the Inclusa team to serve members in the Wisconsin Family Care (FC) program. As a Health & Wellness Coordinator (HWC), you will be responsible for partnering with your fellow colleagues to provide top quality coordination of care to our members. The HWC is responsible for facilitating the coordination, communication, negotiation, and collaboration of streamlined healthcare delivery processes on behalf of the member. You will work closely with a social services care manager (also referred to as a Community Resource Coordinator) and collaborate on an ongoing basis regarding the member and their plan. Your role will involve performing face-to-face health-related assessments for members upon enrollment and at least every six (6) months thereafter in the member's setting. You will coordinate, perform, and track quarterly face-to-face visits and monthly phone contacts. Additionally, you will participate in the development and ongoing review and coordination of the member's plan of care, taking the lead on all health issues for the member. This includes contacting and coordinating with acute and primary care providers, identifying and coordinating clinical and functional supports needed for the member's health and safety, and educating on and promoting prevention and wellness while mitigating risk when assessed. Documentation of activity and completion of paperwork as required is also a key responsibility. This position requires travel, and you will be eligible for mileage reimbursement. The workstyle is field-based, meaning you will perform your core duties at non-company locations, such as providing services at business partner facilities or members' homes. The typical work hours are Monday through Friday, from 8:00 am to 4:30 pm CST.
Responsibilities
Partner with colleagues to provide quality coordination of care to members.
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Facilitate coordination, communication, negotiation, and collaboration of healthcare delivery processes.
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Perform face-to-face health-related assessments for members upon enrollment and every six months thereafter.
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Coordinate, perform, and track quarterly face-to-face visits and monthly phone contacts.
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Participate in the development and ongoing review of the member's plan of care.
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Take the lead on all health issues for the member.
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Contact and coordinate with acute and primary care providers.
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Identify and coordinate clinical and functional supports needed for the member's health and safety.
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Educate on and promote prevention and wellness, mitigating risk when assessed.
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Document activity and complete required paperwork.
Requirements
Associate degree in nursing.
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Must be a Registered Nurse, licensed in the state of Wisconsin.
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Ability to travel up to 40% of the work week throughout Rock and Jefferson counties.
Nice-to-haves
Bachelor's degree in nursing.
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One (1)+ years of experience with Family Care target group: frail elders and adults with intellectual, developmental, or physical disabilities.
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Care Management experience.
Benefits
Health benefits effective day 1
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Paid time off, holidays, volunteer time and jury duty pay
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Recognition pay
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401(k) retirement savings plan with employer match
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Tuition assistance
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Scholarships for eligible dependents
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Parental and caregiver leave
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Employee charity matching program
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Network Resource Groups (NRGs)
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Career development opportunities
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