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 those requiring post-acute services.

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

• Offer patients information and education about service locations, specialty offerings, post-acute care, and related inquiries.

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

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

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

• Advocate for clients throughout the referral process.

• Monitor and follow up on referral and admission results.

• Achieve departmental performance objectives and patient satisfaction targets.

• Support the admissions process by acting as a representative for eligible patients.

• Ensure the right patient is matched with the appropriate care setting at the correct time.

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

• Adhere to all company policies and procedures.

• Inform patients about home health, hospice, and palliative care services.

• Assist in the clinical eligibility assessment for alternate services.

• Engage in special projects and carry out other assigned tasks.

• Report directly to the Manager of Care Management.

• Collaborate with the CenterWell Home Health clinical team to facilitate patient follow-up.

⛳️ 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 post-acute nursing experience is required.

• Experience in home health or hospice is preferred.

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

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

• Strong analytical and problem-solving skills are necessary.

• Excellent verbal and interpersonal communication skills are required.

• Ability to communicate empathetically over the phone.

• A minimum home internet speed of 25 Mbps for download and 10 Mbps for upload is required.

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

• Availability to work 40 hours per week over four 10-hour shifts.

• Willingness to participate in a rotating holiday schedule.

• Flexibility to train outside of the advertised shift when needed.

• Occasional travel to Humana offices for training or meetings may be 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.

• Personal wellness support.

• Smart healthcare decision support.

• Work-from-home arrangement.

• Company-provided training and meetings.

• Additional benefits and opportunities.