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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting assessments and developing care plans while effectively coordinating with healthcare providers and community resources. Proficient in case management, member advocacy, and maintaining compliance with HIPAA regulations.
Highest-signal resume keywords
Case Management ExperienceBilingual CommunicationKnowledge of Medicare & MedicaidBehavioral Health ExperienceElectronic Case Note Documentation
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Assessment ConductingCare Plan DevelopmentProblem ResolutionMember EducationDocumentation of Member Information
Soft Skills
Relationship BuildingAdvocacyInterdisciplinary CollaborationCommunication Skills
Industry Keywords
Community HealthSocial ServicesPreventive Health GuidelinesMember Grievance ProcessPHI/HIPAA Compliance
About the role
Key responsibilities & impact- Conduct initial and annual assessments of members' medical, behavioral, and social needs
- Coordinate assessment information to develop and implement care plans
- Build working relationships with physicians, social service providers, and others in the Care Coordination process
- Assist with problem resolution involving members and providers as a member advocate
- Provide information for the member grievance process
- Review, monitor, and update care plans
- Educate members and providers about benefits, service providers, access protocols, and appropriate use of medical services
- Provide referrals to community resources and social services
- Document member information, contacts, care, and services provided
- Monitor members' willingness to participate in treatment regimens and develop solutions with staff, members, and providers
- Conduct follow-up calls after hospitalizations and emergency room visits
- Participate in or facilitate interdisciplinary care team meetings
- Educate members on preventive health guidelines and programs
- Report directly to the Manager of Care Management Support
- Occasionally travel to Humana offices for training or meetings
Requirements
What you’ll need- Bachelor's degree in health and human services field
- 2 or more years of case management experience
- Must reside within the State of WI
- Minimum download speed of 25 Mbps
- Minimum upload speed of 10 Mbps
- Work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information
- Monday–Friday availability, 8:00 am–5:00 pm CST
- Bilingual preferred
- Prior experience with Medicare & Medicaid recipients preferred
- Prior Behavioral Health experience preferred
- Previous experience with electronic case note documentation preferred
- Knowledge of community health and social service agencies and additional community resources preferred
Benefits
Comp & perks- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Work from home
- Competitive benefits supporting whole-person well-being