[Hiring] Telephonic Case Manager @Humana

Role Description

Become a part of our caring community. Join our team at Humana as a Telephonic Case Manager! You'll work from home, connecting with members over the phone, support their care journeys, and help affect their health and well-being. You'll collaborate with a caring team, build your skills, and bring your empathy to every conversation. You will report directly to the Manager of Care Management Support, who will support your success.

• Conduct initial and annual assessments of members' medical, behavioral and social needs.
• Coordinate and organize information from members' assessment to develop a care plan that addresses their needs and assures implemented interventions are collaborated with members and their providers/supports.
• Build constructive working relationships with physicians, social service providers and others by involving them in the Care Coordination process and assists in problem resolution involving members and providers as a member advocate including information for the member grievance process.
• Review, monitor and update care plans as indicated.
• Provide information to members and providers regarding benefits, service providers and access protocols and educate members on appropriate use of medical services. Provide referrals for community resources and social services.
• Document member information and contacts made regarding member's care and services provided.
• Monitor member's willingness to participate in treatment regimes, and problem solve with staff, members and providers, alternatives or solutions to their needs.
• Conduct follow-up calls post hospitalization and emergency room visits according to policy.
• Contribute to interdisciplinary Care team meetings as either a participant or a facilitator.
• Educate members on preventive health guidelines and programs.

Qualifications

• Bachelor's degree in health and human services field
• 2 or more years of case management experience
• Must reside within the State of WI

Requirements

• Bilingual
• Prior experience with Medicare & Medicaid recipients
• Prior Behavioral Health experience
• Previous experience with electronic case note documentation
• Knowledge of community health and social service agencies and additional community resources

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
• Many other opportunities

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.