Senior Manager, Predictive Modeling
American Family Insurance
JavaPython
Telephonic Care Manager Nurse
Humana
full-time
Posted on:
Location Type: Hybrid
Location: Madison • Wisconsin • 🇺🇸 United States
Visit company websiteSalary
💰 $71,100 - $97,800 per year
Job Level
Mid-LevelSenior
About the role
- connect with members and their families over the phone to assess their needs and help guide them toward resources that support their health and wellbeing
- Perform all duties in alignment with the DHS contract for Medicaid Managed Care Organizations
- Tailor assessments and interventions according to the member’s level of engagement, activation and with consideration of the member’s priorities
- Conduct transitions of care activities to reduce readmissions
- Actively problem solve with staff, members and providers in finding alternatives or solutions to their medical, behavioral health and social needs
- Assists with the oversight of care plans and prioritization of complex medical, behavioral health and social needs
- Recognizes and acts in accordance with the nursing scope of practice and role within the interdisciplinary team
- Participate and contribute to regular member staffings to keep the team informed of updates to the care plan, collectively problem solve and determine the enrollment/graduation of members
- Serves as a consultative resource for other care management staff
- Provides accurate and timely documentation per work processes and guidelines
Requirements
- Bachelor's degree
- 3 - 5 years of clinical acute care and/or care management experience
- Reside within the State of WI
- Licensed Registered Nurse (RN) in the WI with no disciplinary action
- Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
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
clinical acute carecare managementassessmentsinterventionstransitions of careproblem solvingcare plansdocumentation
Soft skills
communicationteam collaborationproblem solvingpassion for consumer experience improvement
Certifications
Bachelor's degreeLicensed Registered Nurse (RN)
