Find & Apply For Registered Nurse Jobs in Park Falls, Wisconsin

Healthcare Case Manager -

Health Insurance Job Reference:

2989949211-2

Date Posted:

27 September 2026

Recruiter:

Humana Location:

Park Falls, Wisconsin Salary:

USD84,000

to

USD96,000

Job Type & Industry:

Risk > Technology Risk, Industry / Employer Sector > Healthcare & Pharmaceutical, Industry / Employer Sector >

Insurance Contract Type:

Permanent Apply for this job now Job Description Humana is seeking a Case Manager to coordinate and optimize care for members within our Healthcare & Medical Services team. In this role, you will complete comprehensive assessments, develop individualized care plans, and collaborate with physicians, pharmacists, and community partners to close care gaps and improve health outcomes. You will educate members on conditions and resources, use data and analytics to identify high-risk cases, and ensure compliance with Medicare, Medicaid, and regulatory requirements. You'll join a member-focused, inclusive, and collaborative culture with strong benefits, flexible work options, and opportunities for ongoing learning and career growth. Responsibilities Coordinate and manage care plans for Humana members across healthcare & medical services. Conduct comprehensive assessments to identify members' clinical, social, and behavioral health needs. Collaborate with providers, pharmacists, and interdisciplinary teams to close care gaps and optimize outcomes. Educate members and families on conditions, treatment plans, and available community resources. Monitor progress, adjust care plans, and document activities in case management systems. Use data and analytics to identify high risk members and prioritize outreach. Ensure compliance with regulatory, Medicare/Medicaid, and Humana policies. Advocate for members to improve access, quality, and affordability of care. Support population health initiatives and quality improvement programs. Participate in ongoing training and share best practices within a collaborative team culture. Required Skills Case management Care coordination Utilization management Clinical assessment Electronic health records (EHR) Health insurance/managed care knowledge Medicare and Medicaid regulations Data analysis and reporting Motivational interviewing Care planning and documentation