Care Manager, Telephonic Nurse

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

📋 Description

• Operate remotely as a telephonic Registered Nurse.

• Report directly to the Manager of Care Management.

• Ensure seamless continuity of care for patients moving into and out of services.

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

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

• Offer patients information and education regarding service sites, specialty offerings, post-acute care, and associated queries.

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

• Assess clinical care levels utilizing discussions, medical records, and other clinical data.

• Align patient needs with service-site locations or identify alternative service options.

• Advocate throughout the referral process to ensure prompt responses and maximize referral-to-admission conversions.

• Follow up on and monitor referral and admission results.

• Stay informed of department performance targets and patient satisfaction objectives.

• Support admissions by acting as an ambassador for qualifying patients.

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

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

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

• Assist in the clinical eligibility review for alternative services.

• Engage in special projects and undertake additional assigned responsibilities.

⛳️ Requirements

• Associate's Degree is required.

• Bachelor's of Science in Nursing (BSN) is preferred.

• Compact state RN license is mandatory; 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.

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

• Strong analytical and problem-solving skills.

• Excellent verbal communication and interpersonal abilities.

• Ability to communicate with empathy over the phone.

• Minimum internet speed of 25 Mbps download and 10 Mbps upload is required.

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

• Must be available for training outside of the advertised shift when required.

• Availability for a rotating holiday schedule is essential.

🏝️ Benefits

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Personal wellness and smart healthcare decision support.

• Occasional travel to Humana's offices for training or meetings.