FCP Case Manager (Healthcare)

Location: Milwaukee, Wisconsin, United States; remote and field-based work with travel throughout Milwaukee County, including member residences. Travel may be required up to 75% of the time, with occasional travel to hirify.global offices for training or meetings. Working hours are Monday through Friday, 8:30am–5:00pm CST.

Salary: $53,700–$72,600 per year.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services to people with Medicare and Medicaid, families, individuals, military personnel, and communities.

What you will do

• Provide care management services through comprehensive assessments, service-plan development, care coordination, quality assurance, and ongoing monitoring.
• Conduct psychosocial assessments and use the Resource Allocation Decision methodology to identify member outcomes, community resources, and cost-effective services or equipment.
• Coordinate and monitor medical, social, rehabilitation, vocational, educational, and other services.
• Reassess care plans, monitor member health and safety, and document member information, contacts, workflows, and audit requirements.
• Collaborate with members, families, physicians, medical professionals, providers, interdisciplinary teams, and outside agencies.
• Support complaints, grievances, advocacy services, referrals, treatment engagement, and resolution of member-provider issues.

Requirements

• Meet one of the following: Wisconsin-certified Social Worker with at least one year of experience with a Family Care target population; a four-year or advanced Human Services degree with at least one year of relevant experience; or a four-year or advanced degree in another field with at least three years of relevant experience.
• Knowledge of community resources and long-term care options.
• Ability to travel to any location within Milwaukee County to conduct assessments in members' residences.
• Valid state driver's license and personal vehicle liability insurance with 100/300/100 limits required.
• Patient-facing work requires participation in hirify.global's tuberculosis screening program.
• Work must support protection of member PHI and HIPAA information.

Nice to have

• Certification or licensure in Social Work in Wisconsin, or eligibility for certification and licensure.
• Previous managed care experience.
• General knowledge of Medicaid and Medicare benefits.

Culture & Benefits

• Full-time schedule of 40 hours per week with mileage reimbursement for work-related travel.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and additional wellness benefits.