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Humana

Sells Medicare health plans and runs senior clinics

Family Care Partnership Registered Nurse Care Manager

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • Must be a Registered Nurse licensed in the State of Wisconsin and in good standing.
  • Must have two years of related health care experience.
  • Must have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
  • Must complete tuberculosis screening if selected.
  • Must have self-provided home internet with at least 25 Mbps download and 10 Mbps upload, and a dedicated workspace without ongoing interruptions to protect member protected health information and HIPAA information.

Responsibilities

  • Complete the nursing portion of the comprehensive assessment and provide input to the member’s care accordingly.
  • 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 response to interventions, or respond to a medical complaint or event affecting the member’s health.
  • Perform routine health monitoring activities based on the member’s needs.
  • Build constructive working relationships with members, their family members, and appropriate outside agency staff.
  • In crisis situations, assess psychiatric, behavioral, or medical problems and implement interventions with other staff to help ensure member safety.
  • Evaluate members’ ability to safely manage medication, medical care interventions and treatments, equipment, and access to health care services.
  • Provide or arrange services, supports, or medical care that best meet members’ identified needs, and monitor the effectiveness of these interventions.
  • Help with program and procedure development and provide input for the quality improvement/quality assurance program.
  • Travel to locations within Milwaukee and surrounding counties to visit members.
  • Travel up to 50% throughout Milwaukee and surrounding counties.
  • Occasionally travel to Humana offices for training or meetings may be required.

Desired Qualifications

  • Previous home health, managed care, or case management experience.
  • General knowledge of Medicaid and Medicare benefits.

About the Company

Humana

Sells Medicare health plans and runs senior clinics

Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.

Company size
10,001+
Company stage
IPO
Headquarters
Louisville, KY
Founded
1961

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