Case Manager- Dodge County, WI at Humana

Beaver Dam, Wisconsin, United States

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Not SpecifiedCompensation

Junior (1 to 2 years), Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Social ServicesIndustries

Requirements

Four-year bachelor’s degree in human services or related field with one (1) year of experience working with at least one of the Family Care target populations (frail elders and adults with intellectual, developmental, or physical disabilities) OR a four-year bachelor’s degree in any other field with three (3) years’ related experience working with at least one of the Family Care target populations
Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications

Responsibilities

Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP)
Coordinate services that address members’ health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP
Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members’ evolving needs
Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member’s residence
Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone
Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs
Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery
Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness
Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan
Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes
Travel to conduct member visits and fulfill role responsibilities (up to 40% throughout Dodge County, WI and surrounding areas, serving members in Polk and Burnett Counties)

Skills

Key technologies and capabilities for this role

Case ManagementSocial AssessmentsCare PlanningService CoordinationRisk AssessmentCommunity ResourcesMember EngagementDocumentation

Questions & Answers

Common questions about this position

What qualifications are required for the Case Manager position?

A four-year bachelor’s degree in human services or related field with one year of experience working with Family Care target populations is required, or a bachelor’s degree in any field with three years of related experience. Intermediate computer proficiency, including Microsoft Office, is also necessary.

Is travel required in this role?

Yes, travel is necessary to conduct member visits and fulfill role responsibilities.

What is the salary for this Case Manager position?

This information is not specified in the job description.

What does the team environment look like at Humana for this role?

You will collaborate closely with dedicated colleagues, including a Field Care Nurse (RN), to deliver exceptional care and review care plans.

What experience makes a strong candidate for this position?

Candidates with a bachelor’s degree in human services and at least one year of experience with frail elders or adults with intellectual, developmental, or physical disabilities, plus computer proficiency, will stand out.

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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