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Humana

Sells Medicare health plans and runs senior clinics

Case Manager

Case Management & AdvocacyPosted on Nov 9
Full-timeWisconsin, USA$53.7k - $72.6k /yr

About the Job

Requirements

  • A bachelor's degree in human services or a related field and at least one year of experience serving frail elders or adults with intellectual, developmental, or physical disabilities, or a bachelor's degree in another field and at least three years of such experience.
  • Travel up to 40% of the time to visit members.
  • A valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
  • A download speed of at least 25 Mbps and an upload speed of at least 10 Mbps for home internet; wireless, wired cable, or DSL connection is suggested.
  • Work from a dedicated space without ongoing interruptions to protect member protected health information and HIPAA information.
  • Complete tuberculosis screening if selected for this patient-facing role.

Responsibilities

  • Assess members' health and safety needs to identify their strengths, interests, and preferences and develop a comprehensive Member Care Plan (MCP).
  • Coordinate with a Field Care Nurse to address members' health and safety needs and ensure the team provides support in the least restrictive environment in accordance with the MCP.
  • Travel to members' locations to conduct face-to-face social assessments upon enrollment and at least every six months, typically at members' residences.
  • Travel to members' homes for quarterly in-person visits and maintain monthly contact with members by phone.
  • Arrange support services for members, including services related to social integration, community resources, employment, housing, and other non-medical needs.
  • Ensure cost-effective service delivery.
  • Evaluate risk factors and provide education to members.
  • Maintain accurate documentation, including case notes, service authorizations, and updates to the MCP.
  • Participate in Humana's driver safety program.
  • Travel to Humana offices occasionally for training or meetings, as required.

Desired Qualifications

  • Reside within 45 minutes or less of the assigned coverage area.
  • Have case management experience.
  • Have experience with electronic case-note documentation.
  • Have knowledge of community health and social service agencies and additional community resources.

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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