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 in need of post-acute care.

• Guide patients through healthcare options, post-acute care services, Medicare coverage, billing inquiries, and healthcare resources.

• Offer education and options to patients regarding sites of service, specialty offerings, post-acute care, and related inquiries.

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

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

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

• Advocate for clients throughout the referral process to ensure prompt responses and enhance referral-to-admission conversion rates.

• Monitor and follow up on referral and admission outcomes.

• Contribute to departmental performance objectives and enhance patient satisfaction.

• Act as an ambassador for eligible patients during the admissions process.

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

• Assist with clinical eligibility assessments for alternative services.

• Engage in special projects and fulfill other assigned duties.

• Complete necessary training in HIPAA, Business Ethics and Compliance, and company policies.

• 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 needs.

• 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.

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

• Strong analytical and problem-solving abilities.

• Excellent verbal and interpersonal communication skills.

• Capability to communicate with empathy over the phone.

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

• A dedicated workspace free from interruptions to safeguard member PHI/HIPAA information.

• Availability for up to 19 hours per week, Monday-Friday from 5pm-7am ET, and all day Saturday and Sunday.

• Must be available for 3 weekend shifts per month and 3 holidays each year.

• Willingness to train outside the advertised shift times.

🏝️ Benefits

• Paid time off.

• 401(k) retirement savings plan.

• Employee assistance program.

• Business travel and accident benefits.