Case Manager

Humana Insurance Company
Ashland, WI Full Time
POSTED ON 11/14/2023 CLOSED ON 12/19/2023

What are the responsibilities and job description for the Case Manager position at Humana Insurance Company?

Description Humana is seeking a Social Worker/Case Manager, aka: Community Resource Coordinator (CRC), to join the Inclusa team to serve members in the Wisconsin Family Care (FC) program. In this role, you will be responsible for partnering with your fellow colleagues to provide top quality care to our members. They are looking to you in providing assistance when it comes to living their daily lives. The CRC provides comprehensive social service care management for frail elders and adults with intellectual, developmental or physical disabilities who qualify for Wisconsin’s FC program. Responsibilities Learn what is important to the member and support them in achieving it. Partner with a Health and Wellness Coordinator (RN) and collaborate on an ongoing basis regarding the member and their plan. Perform face-to-face social-related assessments for members upon enrollment and at least every 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 in areas related to social, community integration, employment, housing, and non-health related issues. Educate on and promote prevention/wellness and mitigate risk when assessed. Document activity and complete paperwork as required. Traveling will be required and eligible for mileage reimbursement. Required Qualifications Four-year bachelor’s degree in the Human Services or related field with one (1) year of experience working with at least one of the Family Care target populations OR a four-year bachelor’s degree in any other field with three (3) years’ related experience working with at least one of the Family Care target populations. ***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities*** Preferred Qualifications Certification in social work 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: Ashland, Wisconsin and surrounding area. Travel: up to 40% throughout Ashland, WI and surrounding area. Typical Work Days/Hours: Monday – Friday, 8:00 am – 4:30 pm CST Limited Geography Remote - This is a remote position but located within a specific geography. 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. 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. Scheduled Weekly Hours 40
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