Care Manager, Telephonic Nurse

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

📋 Description

• Assist patients who have been discharged from CenterWell Home Health services or require post-acute care services.

• Guide patients through healthcare alternatives, post-acute care options, Medicare coverage, billing concerns, and available healthcare resources.

• Educate patients on service site choices, specialty services, and post-acute care opportunities.

• Address customer inquiries such as location searches, directions, and complaints.

• Assess the clinical level of care based on discussions, medical documentation, and other clinical information.

• Connect patients with suitable service locations or suggest alternative service options.

• Advocate for customers during the referral process.

• Monitor referral and admission results.

• Contribute to departmental performance goals and enhance patient satisfaction.

• Support the admissions process as an ambassador for qualified patients.

• Provide information regarding Home Health, Hospice, and Palliative Care Services.

• Assist with clinical eligibility evaluations for alternative services.

• Maintain communication with the CenterWell Home Health clinical team.

• Engage in mandatory training sessions, special projects, and other assigned tasks.

• Report directly to the Manager of Care Management.

⛳️ Requirements

• An Associate's Degree is required; a BSN is preferred.

• A compact state RN license is required.

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

• A minimum of 3 years of nursing experience in a post-acute care setting.

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

• Capability to learn and master information related to client locations and services.

• Strong analytical and problem-solving abilities.

• Excellent verbal and interpersonal communication skills.

• Ability to communicate empathetically over the phone.

• Minimum home internet speed of 25 Mbps for downloads and 10 Mbps for uploads.

• A designated workspace free from interruptions to maintain the confidentiality of member PHI/HIPAA information.

• Availability to work Monday through Friday from 9 am to 5:30 pm EST, every third weekend, and participate in a rotating holiday schedule.

🏝️ 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.

• Work-from-home arrangement.

• Occasional travel to Humana offices for training or meetings.