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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in developing comprehensive Member Care Plans and conducting health assessments while ensuring compliance with DHS contract timeframes. Proficient in coordinating care with providers and educating members on health-related topics, with a strong focus on documentation and risk management.
Highest-signal resume keywords
Licensed Registered NurseCare Management ExperienceHealth AssessmentD365 System ProficiencyHIPAA Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Member Care PlansHealth AssessmentsDocumentationRecord ReviewRemediation Updates
Soft Skills
CommunicationTeam SupportProblem Solving
Tools & Technologies
D365 System
Certifications & Qualifications
Associate Degree in NursingLicensed Registered Nurse in Wisconsin
Industry Keywords
Care ManagementHealth and Safety NeedsDisease EducationNutritionLifestyle ModificationsTB ScreeningPersonal Vehicle Liability Insurance
About the role
Key responsibilities & impact- Assess members’ health and safety needs to develop comprehensive Member Care Plans
- Conduct regular health assessments
- Coordinate with acute and primary care providers
- Educate members on disease processes, risks, nutrition, exercise, and lifestyle modifications
- Document in member files within required DHS contract timeframes
- Participate in monthly member phone contacts and travel for in-person member visits
- Work from home and travel approximately 40% to visit members
- Complete record reviews for reassigned members and identify needed remediation
- Complete documentation for evident remediation updates
- Inform newly assigned RNs and Care Coach partners of missed or needed follow-up
- Assign tasks in the D365 system as needed
- Provide support for record review and remediation
- Support the team through process changes
- Accept additional complex member assignments
- Provide additional support with new member assignments
- Inform Managers of significant risks or concerns identified during record reviews
Requirements
What you’ll need- Associate degree in nursing
- Licensed Registered Nurse in the state of Wisconsin (in good standing)
- Preferred: 1 year Care Management experience
- Preferred: Reside within 45 mins or less of the assigned coverage area
- Previous Care Management experience preferred
- Valid state driver's license
- Proof of personal vehicle liability insurance with at least 100/300/100 limits
- Required to undergo TB screening if selected
- Minimum home internet speed of 25 Mbps download and 10 Mbps upload
- Dedicated workspace without ongoing interruptions to protect member PHI / HIPAA information
Benefits
Comp & perks- No night or weekend shifts
- Bonus incentive plan based upon 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
- Home-based work arrangement
- Occasional travel to Humana offices for training or meetings