Care Manager, Telephonic Nurse

• This is a full time position scheduled for 40 hours a week over 4 days for 10 hour shifts. Every other week the schedule will be as follows:

-Week 1 schedule: Monday, Thursday, Friday & Saturday from 10:30am-9pm EST.

-Week 2 schedule: Sunday, Tuesday, Thursday & Friday from 10:30am-9pm EST.

• Required to work a rotating holiday schedule.
• Available to train on days or times outside of the shift advertised.
• Shift/Availability changes may be required based on patient care needs and business demands.

This is a work-from-home telephonic Registered Nurse position.

As a Care Manager, Telephonic Nurse, you will report directly to the Manager, Care Management. You will help to ensure optimal continuity of care for patients transitioning into and out of our services. You will be responsible for being knowledgeable regarding post-acute levels of care, and an expert regarding CenterWell Home Health services including home health, hospice, and palliative care. You will communicate with the CenterWell Home Health clinical team and help facilitate patient follow-up for patients in need of (additional) services.

• Be a CenterWell Home Health representative in supporting patients who have been discharged from service or for those who may need post-acute services. Navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, and accessing healthcare resources.
• Use a variety of tools and methods to quickly provide patient options and education including but not limited to sites of service, specialty offerings, post-acute care, and other related questions. Handle a variety of customer issues including location lookup, directions, and complaints.
• Make clinical level of care determination based on discussion, medical records, and any other important clinical data. Match these needs to a service site location or, if not available, look up and provide alternative services. Be a customer advocate throughout the referral process to ensure timely response and to maximize referral to admission conversion rate. Follow-up and track referral and admission outcomes.
• Maintain awareness and orientation to department performance objectives, meets standards, and assures patient satisfaction goals are met.
• Assist in the admissions process by acting as an ambassador for patients who meet the admissions requirements.
• Focus on placing the right patient to the right care setting at the right time.
• Adhere to and participates in Company's mandatory training which includes but is not limited to HIPAA privacy program/practices, Business Ethics and Compliance programs/practices, and Company policies and procedures.
• Review and adhere to all Company policies and procedures.
• Provide education regarding Home Health, Hospice, and Palliative Care Services.
• Help with clinical eligibility review for alternate services.
• Participate in special projects and perform other responsibilities as assigned.

• Associates Degree required. BSN preferred.
• We require a compact state RN license. Business needs may require additional state licensures be obtained.
• At least 3 years post-acute nursing experience. Home health or hospice experience preferred.
• Knowledge of home health, hospice, and palliative care services.
• Learn and master information related to locations and services of clients.
• Analytical and can problem-solve.
• Excellent verbal and interpersonal skills.
• Communication with empathy over the phone.

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.