FCP RN Care Manager- Baraboo at Humana

Baraboo, Wisconsin, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

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 Dane, Adams, Columbia, Dodge, Green Lake, Iowa, Jefferson, Marquette, Rock and Waushara counties
Proven ability to learn new software applications

Responsibilities

Complete the nursing portion of the comprehensive assessment and provide input to the member’s care accordingly
Establish and 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, provide appropriate assessment of psychiatric, behavioral or medical problems and implement 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
Take appropriate measures to prevent the spread of infection and communicable diseases and instruct the member and/or caregiver in these measures
Ensure that the member’s physician or appropriate medical professional is notified when the member has an acute change in condition
Provide or arrange for services, supports or medical care that best meet the member’s identified needs, and monitor the effectiveness of these interventions
Assist in problem resolution between members and providers
Occasionally assist in conducting presentations to outside agencies and organizations
Assist with program, policy, and procedure development and assist with input for the QI/QA program

Skills

Nursing

Case Management

Care Planning

Health Assessment

Home Visits

Community Health

Interdisciplinary Team

Wellness Promotion

Crisis Intervention

Medication Management

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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