Care Manager, Telephonic Nurse

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

📋 Description

• Ensure the highest level of care continuity for patients transitioning in and out of services.

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

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

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

• Address customer concerns, including location searches, directions, and complaints.

• Assess clinical levels of care through discussions, medical records, and other clinical information.

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

• Advocate for clients throughout the referral process.

• Follow up and monitor referral and admission results.

• Contribute to departmental performance objectives and patient satisfaction targets.

• Assist with admissions by acting as a patient ambassador.

• Educate on Home Health, Hospice, and Palliative Care Services.

• Aid in clinical eligibility assessments for alternative services.

• Participate in required HIPAA, Business Ethics and Compliance, and company policy training.

• Engage in special projects and perform other assigned duties.

• Report directly to the Manager of Care Management.

⛳️ Requirements

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

• A current compact state RN license is mandatory.

• Additional state licenses may be required based on business needs.

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

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

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

• Strong analytical and problem-solving abilities.

• Excellent verbal and interpersonal communication skills.

• Capable of conveying empathy over the phone.

• A minimum home internet speed of 25 Mbps for downloads and 10 Mbps for uploads is required.

• A dedicated workspace free from interruptions is necessary to protect member PHI/HIPAA information.

• Availability is required for Monday to Friday from 9 am to 5:30 pm EST, every third weekend, rotating holidays, and training outside the scheduled shift when necessary.

🏝️ 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.