Unknown Company is hiring a Care Manager, Telephonic Nurse

CenterWell Home Health, a Humana company, is looking for a Care Manager, Telephonic Nurse to ensure optimal continuity of care for patients transitioning into and out of services. In this work-from-home role, you’ll act as a company representative, supporting patients discharged from service or needing post-acute care by facilitating timely follow-up and guidance.

What You'll Do

• Act as the CenterWell Home Health representative for patients discharged from service or needing post-acute services.
• Navigate healthcare options, post-acute care services, Medicare coverage, billing issues, and healthcare resources.
• Utilize tools to provide patient options and education on sites of service, specialty offerings, and post-acute care.
• Handle customer issues including location lookup, directions, and complaints.
• Make clinical level of care determinations based on discussion and medical records.
• Match patient needs to service site locations or provide alternative services.
• Act as a customer advocate to ensure timely response and maximize referral to admission conversion.
• Follow-up and track referral and admission outcomes.
• Maintain awareness of department performance objectives and meet standards.
• Assist in the admissions process as an ambassador for eligible patients.
• Focus on placing the right patient to the right care setting at the right time.
• Adhere to and participate in mandatory HIPAA, Business Ethics and Compliance, and company policy training.
• Provide education regarding Home Health, Hospice, and Palliative Care Services.
• Assist with clinical eligibility review for alternate services.
• Participate in special projects and perform other duties as assigned.

What We're Looking For

• Associates Degree.
• RN license in a compact state.
• At least 3 years post-acute experience.
• Nursing background working across multiple areas of post-acute care.
• Extensive nursing experience in post-acute care.
• Current CPR certification.
• Good working knowledge of home health, hospice, and palliative care services.
• Good time management skills.
• Ability to learn and master information related to locations and services of clients.
• Excellent analytical and problem-solving skills.
• Excellent verbal and interpersonal skills.
• Able to communicate effectively with empathy over the phone.
• Must read, write and speak fluent English.
• Internet service with minimum download speed of 25 Mbps and upload speed of 10 Mbps.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice to Have

• BSN.
• Home Care or hospice experience.

Team & Environment

You will work under the general supervision of the Manager of Care Coordination.

Benefits & Compensation

• Compensation range: $71,100 - $97,800 per year.
• Health benefits effective day 1.
• Paid time off, holidays, and jury duty pay.
• Recognition pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance.
• Scholarships for eligible dependents.
• Caregiver leave.
• Employee charity matching program.
• Network Resource Groups (NRGs).
• Career development opportunities.

Work Mode

This is a remote position.

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.