RN Care Manager - Baldwin, WI

Become a part of our caring community and help us put health first Humana is seeking an RN Care Manager (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.
They are looking to you in providing assistance when it comes to living their daily lives.
The HWC is responsible for facilitating the coordination, communication, negotiation, and collaboration of streamlined healthcare delivery processes on behalf of the member.
Partner 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.
Perform face-to-face health-related assessments for members upon enrollment and at least every six (6) months thereafter in the member’s setting.
Coordinate, perform, and track quarterly face-to-face visits and monthly phone contacts.
Participate in the development and ongoing review and coordination of the member’s plan of care.
Take the lead on all health issues for the member.
Contact and coordinate with acute and primary care providers.
Identify and coordinate clinical and functional supports needed for the member’s health and safety.
Educate on and promote prevention and wellness and mitigate risk when assessed.
Document activity and complete paperwork as required.
Traveling will be required and eligible for mileage reimbursement.
Use your skills to make an impact Required Qualifications Associate degree in nursing.
Must be a Registered Nurse, licensed in the state of Wisconsin.
Preferred Qualifications Bachelor degree in nursing.
One (1)+ years of experience with Family Care target group: frail elders and adults with intellectual, developmental, or physical disabilities.
Care Management experience.
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.
Work Location: Baldwin, Wisconsin and surrounding area.
Travel: up to 40% throughout Baldwin, WI and surrounding area.
Typical Work Days/Hours: Monday through Friday, 8:00 am – 4:30 pm CST.
WAH Internet Statement To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
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.
Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families.
We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Modern Hire As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability.
Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
SSN Alert Humana values personal identity protection.
Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file.
When required, an email will be sent from Humana@myworkday.
com with instructions on how to add the information into your official application on Humana’s secure website.
Scheduled Weekly Hours 40 About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin.
As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved.
In 2022, Inclusa was acquired by Humana.
This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.
About Humana: Humana Inc.
(NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran.
It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements.
This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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