RN Care Manager – Lead
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Job Description
RN Care Manager Lead coordinating complex member care for Humana/iCare’s Wisconsin Family Care Partnership program. Mentoring nurses and care coaches while coordinating medical, behavioral, and social services.
Responsibilities:
- Provide lead care management services through the Family Care Partnership program
- Mentor FCP nurses and care coaches
- Arrange field shadowing and applications for new care managers and nurses during orientation
- Communicate employee participation and progress in mentoring activities to managers
- Educate and coach staff on care management, RN roles, interdisciplinary teamwork, and contractual compliance
- Provide ongoing training on the Family Care model and supplementary best practices
- Identify, coordinate, implement, and evaluate external training
- Conduct nursing assessments during initial comprehensive assessments and reassessments
- Use Resource Allocation Decision-making methodology
- Coordinate and monitor services and resources supporting member outcomes
- Conduct RN reassessments, update care plans, and monitor member health and safety
- Help members and families access medical, social, rehabilitation, vocational, educational, and other services
- Assist members or representatives with complaints, grievances, and advocacy services
- Collaborate with the Interdisciplinary Team to address complex medical, psychiatric, behavioral health, and social needs
Requirements:
- Registered Nurse licensed in the State of Wisconsin and in good standing
- 2 years of Managed Care experience
- Must reside within a commutable distance of the Family Care Partnership service area in Southeast Wisconsin
- Ability to travel approximately 20% throughout Kenosha, Racine, Milwaukee, Waukesha, Walworth, Washington, and Sheboygan
- Valid state driver's license
- Proof of personal vehicle liability insurance with at least 100/300/100 limits
- Patient-facing role requiring TB screening
- Minimum home internet speed of 25 Mbps download and 10 Mbps upload
- Ability to work from a dedicated space protecting member PHI/HIPAA information
- Preferred: bilingual English and Spanish skills
- Preferred: training or mentoring experience
- Preferred: knowledge of community health and social service agencies and community resources
Benefits:
- Bonus incentive plan based on company and/or individual performance
- Medical, dental, and vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company and personal holidays
- Paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
- Mileage reimbursement for work-related travel
- Occasional travel to Humana offices for training or meetings
- Dedicated-space home working arrangement
- Self-provided internet requirements for home or hybrid work
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