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Humana

Sells Medicare health plans and runs senior clinics

Registered Nurse Care Manger - Juneau Cty

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeMauston, WI, USA

About the Job

Requirements

  • Associate degree in nursing.
  • Licensed Registered Nurse in good standing in the state of Wisconsin.
  • A valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
  • A home internet connection with at least 25 Mbps download and 10 Mbps upload speed.
  • A dedicated workspace without ongoing interruptions to protect member protected health information and HIPAA information.
  • Complete required tuberculosis screening if selected.

Responsibilities

  • Assess members’ health and safety needs and develop a comprehensive Member Care Plan.
  • Conduct regular health assessments.
  • Coordinate with acute and primary care providers.
  • Educate members on disease processes and related risks, nutrition, exercise, and lifestyle modifications to support informed decision-making while respecting each person’s autonomy.
  • Document in member files within required Department of Health Services contract timeframes.
  • Participate in monthly member phone contacts and travel to attend in-person visits in members’ settings.
  • Work from home and travel approximately 40% of the time to visit members.
  • Review records for reassigned members, including identifying areas requiring remediation.
  • Complete record remediation documentation when needed updates are evident and can be completed during the review process.
  • Ensure newly assigned registered nurses and their Care Coach partners are informed of missed or needed follow-up, including assigning tasks in the D365 system as needed.
  • Support record review and remediation.
  • Support the team as it adapts to and navigates change.
  • Accept additional complex member assignments.
  • Provide additional support with new member assignments.
  • Inform managers of significant risks or concerns identified during record reviews.

Desired Qualifications

  • One year of Care Management experience.
  • Reside within 45 minutes or less of the assigned coverage area.
  • Previous Care Management experience.

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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