Care Manager – Telephonic Nurse

This is a fully remote position, open to applicants in United States.

📋 Description

• Ensure seamless continuity of care for patients as they transition into and out of services.

• Act as a representative for CenterWell Home Health for patients who have been discharged and those requiring post-acute services.

• Navigate through healthcare options, post-acute care services, Medicare coverage, billing problems, and healthcare resources.

• Provide education and options to patients regarding service locations, specialty offerings, post-acute care, and related inquiries.

• Address customer issues, including location inquiries, directions, and complaints.

• Assess the clinical level of care by utilizing discussions, medical records, and other clinical data.

• Align patient needs with appropriate service locations or suggest alternative services when necessary.

• Advocate for patients throughout the referral process.

• Monitor and track referral and admission outcomes.

• Achieve departmental performance objectives and patient satisfaction targets.

• Assist with admissions by acting as an ambassador for eligible patients.

• Ensure the right patient is placed in the appropriate care setting at the right time.

• Complete required training on HIPAA, business ethics, compliance, and company policies.

• Adhere to all company policies and procedures.

• Educate patients about Home Health, Hospice, and Palliative Care Services.

• Support clinical eligibility evaluations for alternative services.

• Engage in special projects and undertake other assigned responsibilities.

• Communicate with CenterWell Home Health clinical teams and facilitate patient follow-up.

• Report directly to the Care Management Manager.

⛳️ Requirements

• An Associate's Degree is required.

• A BSN is preferred.

• A compact state RN license is mandatory.

• Additional state licenses may be necessary based on business requirements.

• A minimum of 3 years of post-acute nursing experience is required.

• Home health or hospice experience is preferred.

• Familiarity with home health, hospice, and palliative care services is essential.

• Capability to learn and master client locations and services.

• Strong analytical and problem-solving skills.

• Exceptional verbal and interpersonal communication skills.

• Ability to communicate with empathy over the phone.

• Internet service must have a minimum of 25 Mbps download and 10 Mbps upload speeds.

• A dedicated workspace is required to prevent ongoing interruptions and to safeguard member PHI/HIPAA information.

• Availability for Monday-Friday from 9:00am to 5:30pm EST is required, along with weekend coverage every third weekend and rotating holidays.

• Willingness to train outside of the advertised shift when necessary.

• Flexibility to accommodate schedule and shift changes based on patient care and business needs.

🏝️ Benefits

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Personal wellness support.

• Smart healthcare decision support.

• Work-from-home arrangement.

• Training and meeting opportunities.