Remote Humana Rn Jobs in Madison, WI (NOW HIRING)

Are you a Registered Nurse with experience in complex care and a passion for improving the lives of individuals with high-acuity health needs? Join our team at Quartz, where you’ll play a crucial role in enhancing the health outcomes of our members through specialized care.

As an RN Complex Care Specialist, you will lead the management and coordination of care for members with high-acuity health needs. Your responsibilities will include conducting clinical assessments, developing individualized care plans, and collaborating with providers and families to optimize health outcomes. Additionally, you will evaluate member self-management skills, identify barriers, and utilize shared decision-making models to enhance their ability to manage chronic conditions effectively.

Benefits:

• 8 am – 5 pm, full-time hours and no weekends or holidays.
• Supportive and experienced team members to assist with training and complex cases
• Opportunity to exercise clinical judgement and serve as a trusted Subject Matter Expert to positively impact the care and lives of Quartz patients.
• Compensation starting pay range: $72,500-$90,600.

• Conduct thorough assessments to determine member health objectives and obstacles to care.
• Develop and implement individualized care plans in collaboration with the care team.
• Act as a strong advocate, valuable resource, and dedicated educator for members and their families.
• Leverage chronic disease management concepts, including health screenings and other preventive health activities to support member's self-management skills.
• Coordinate care transitions and ensure continuity across providers, services, and settings.
• Adhere to relevant NCQA standards to ensure that all outreach, care plans, and assessments fully comply with NCQA requirements.

• Active WI RN or compact state license is a mandatory requirement.
• Bachelor or Associates Degree in Nursing.
• 3 + years in clinical nursing, case management, or care coordination.
• Experience with complex care or chronic disease management preferred.
• Strong critical thinking and problem-solving abilities.
• Excellent communication and interpersonal skills to engage diverse populations.
• Proficiency with electronic health records (EHR) and care management systems.
• Knowledge of and skills in complex care management using CCM, CMSA, and/or ACM models.
• Collaborate with team to meet Key Performance Indicators (KPI's).
• Proficiency using Epic systems and remote monitoring programs.
• Cultural competence and sensitivity to work with individuals from varied backgrounds.
• Case Management (CCM) certification preferred or willingness to obtain within one year.

Quartz offers an excellent benefit and compensation package, opportunity for career advancement and a professional culture built upon the foundations of Respect, Responsibility, Relationships & Resourcefulness. Quartz is a federal contractor and supports a safe, drug-free workplace. All employment offers are contingent upon successful completion of a pre-employment criminal background check.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.