Care Manager, Telephonic Nurse, Anywhere

R-380301

Become a part of our caring community and help us put health first

This full time position will not have a set shift and will be scheduled for 8 hours shifts between the hours of 7am-7pm EST. This position also requires a weekend rotation every third weekend as well as a holiday rotation. When working weekends, it will allow for off-days during the week.

The Clinical Care Coordinator helps to ensure optimal continuity of care for patients transitioning into and out of our services. They are responsible for being highly knowledgeable regarding post-acute levels of care, and an expert regarding CenterWell Home Health services including home health, hospice, and palliative care. The Clinical Care Coordinator is expected to communicate with the CenterWell Home Health clinical team and help facilitate timely patient follow-up for patients in need of (additional) services when appropriate. The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a work-from-home telephonic nurse position

Essential Functions:
• Act as CenterWell Home Health representative in supporting patients who have been discharged from service or for those who may need post-acute services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources.
• Utilize a variety of tools and methods to quickly provide patient options and education including but not limited to sites of service, specialty offerings, post-acute care, and other related questions. Appropriately handle a variety of customer issues including location lookup, directions, and complaints.
• Makes clinical level of care determination based on discussion, medical records, and any other pertinent clinical data. Matches these needs to a service site location or, if not available, look up and provide alternative services. Act as customer advocate throughout the referral process to ensure timely response and to maximize referral to admission conversion rate. Follow-up and track referral and admission outcomes.
• Maintains awareness and orientation to department performance objectives, meets standards, and assures patient satisfaction goals are met.
• Assists in the admissions process by acting as an ambassador for patients who meet the admissions requirements.
• Focus on placing the right patient to the right care setting at the right time
• Adheres to and participates in Company’s mandatory training which includes but is not limited to HIPAA privacy program/practices, Business Ethics and Compliance programs/practices, and Company policies and procedures.
• Reviews and adheres to all Company policies and procedures.
• Provide education regarding Home Health, Hospice, and Palliative Care Services.
• Assist with clinical eligibility review for alternate services
• Participates in special projects and performs other duties as assigned.

Use your skills to make an impact

Required Experience/Skills:
• Associates Degree required. BSN preferred.
• RN license in a compact state is required. May be required to obtain licensure in additional states as dictated by business needs.
• At least 3 years post-acute experience. Home Care or hospice experience preferred.
• 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 and while interacting with others.
• Must read, write and speak fluent English.

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

CenterWell Home Health offers a variety of benefits to promote the best health and well-being of our employees and their families. Our competitive and flexible benefits surround you with support the same way you do for our patients and members, including:
• 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

Travel: While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$71,100 – $97,800 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 07-03-2025