Manager, Provider Network Management
Elevance Health
Case Manager
Humana
full-time
Posted on:
Location Type: Hybrid
Location: Eau Claire • Wisconsin • 🇺🇸 United States
Visit company websiteSalary
💰 $53,700 - $72,600 per year
Job Level
Junior
About the role
- Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP)
- Coordinate services that address members’ health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP
- Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members’ evolving needs
- Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member’s residence
- Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone
- Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs
- Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery
- Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness
- Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan
- Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes
- Travel is necessary to conduct member visits and fulfill role responsibilities
Requirements
- Four-year bachelor’s degree in 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
- Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications.
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- many other opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
Member Care Plan (MCP)social assessmentscase documentationrisk evaluationservice authorizationscommunity resource coordinationhealth and safety needs assessmentsupport service monitoringempathetic communicationdecision-making support
Soft skills
collaborationclear communicationempathyorganizationproblem-solvingtime managementinterpersonal skillsadaptabilityactive listeningrelationship building
