Case Manager

Humana is seeking a Case Manager in Viroqua to coordinate holistic care for our members in the Healthcare & Social Assistance space. In this role, you will assess members' medical, behavioral, and social needs, develop individualized care plans, and connect them with providers, community resources, and support services. You'll monitor progress, document outcomes, and collaborate with interdisciplinary teams. Join a member-focused, inclusive culture with competitive pay, strong benefits, flexible options, and growth opportunities while improving health outcomes in the community.

Responsibilities

• Manage a caseload of Humana members, conducting assessments to identify medical, behavioral, and social needs.
• Develop, implement, and update individualized care plans focused on improving health outcomes and independence.
• Coordinate services across providers, facilities, and community resources to close gaps in care.
• Monitor member progress through regular outreach, documentation, and data tracking in EHR systems.
• Educate members and families on conditions, treatment options, and available benefits and programs.
• Collaborate with nurses, physicians, social workers, and other team members in an integrated care model.
• Support safe transitions of care after hospital or facility discharges to reduce readmissions.
• Advocate for members, addressing barriers such as transportation, housing, and medication access.
• Ensure compliance with Humana policies, quality standards, and regulatory requirements.
• Participate in performance improvement initiatives and use analytics insights to guide interventions.

Required Skills

• Care coordination
• Patient assessment
• Utilization review
• Electronic health records (EHR)
• Discharge planning
• Community resource navigation
• Chronic disease management
• Motivational interviewing
• Data and outcomes reporting
• Interdisciplinary collaboration