Become a part of our caring community
 

The Care Management Telephonic Nurse is a licensed registered nurse who works within an interdisciplinary team to support Independent Care members with complex, episodic medical, behavioral health, and social needs. You will report to the Manager of Care Management Support. You will work alongside health care providers, behavioral health professionals, and social service agencies to promote high quality, efficient, and cost effective delivery of health and social services through assessment, care planning, coordination, and ongoing monitoring.

• Assist Care Coordinators and Care Managers in the oversight, development, and prioritization of member care plans addressing complex medical, behavioral health, and social needs.
• Monitor member status and direct members to appropriate specialty services, community resources, and alternative treatment settings.
• Participate in coordinating member discharge needs in collaboration with facility discharge planners, Care Coordinators, Care Managers, and behavioral health personnel, and assists with medical transitions of care.
• Coordinate services, communicate clinical information, and interface with health care providers regarding the management of current medical, behavioral health, and social needs.
• Support the high risk and complex case management team with completing comprehensive assessments and managing members
• Educate on chronic conditions and preventive health measures -
• Interpret and administer benefits following regulatory requirements, contractual obligations, and medical management guidelines.
• Problem‑solve with staff, members, and providers to identify appropriate alternatives or solutions to care needs.
• Complete accurate, timely, and compliant documentation following iCare policies, workflows, and documentation standards.
• Participate in interdisciplinary team meetings as a member or facilitator.
• Be a clinical resource to iCare staff and assist with training and mentoring of employees.
• Occasionally assist in developing and delivering presentations to external agencies or organizations.
• Support program development, policy and procedure enhancements, and provide input to Quality Improvement and Quality Assurance initiatives.
• Perform other duties as assigned, including mentoring and special projects.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's degree
• Minimum 2 years of clinical acute care experience
• Licensed Registered Nurse (RN) in WI with no disciplinary action.

Preferred Qualifications

• Experience with case management, discharge planning and patient education for adult acute care
• Managed care experience
• Reside within the State of WI

Additional Information

• Workstyle: Hybrid Home
• Work Location: Remote within Wisconsin
• Typical Work Days/Hours: Monday through Friday, 8:30 am – 5:00 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 required; 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.

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, kno