Care Manager - Telephonic Nurse PT Sat and Sun 8a - 4:30p

Remote Full-time
Care Manager - Telephonic Nurse PT Sat and Sun 8a - 4:30p

Part time (20 hours/week) clinical triage nurse and contact center support. Every weekend requirement. Holiday rotation requirement.

Essential Functions:
• Act as a CenterWell Home Health representative in supporting patients who have been discharged from service or for those who may need post-acute services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources.
• Utilize 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. Appropriately handle a variety of customer issues including location lookup, directions, and complaints.
• Makes clinical level of care determination based on discussion, medical records, and any other pertinent clinical data. Matches these needs to a service site location or, if not available, look up and provide alternative services. Act as 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.
• Maintains awareness and orientation to department performance objectives, meets standards, and assures patient satisfaction goals are met.
• Assists 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
• Adheres 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.
• Reviews and adheres to all Company policies and procedures.
• Provide education regarding Home Health, Hospice, and Palliative Care Services.
• Assist with clinical eligibility review for alternate services
• Participates in special projects and performs other duties as assigned.

Required Qualifications
• Licensed Registered Nurse (RN) with compact state licensure in state of residence with no disciplinary action
• 3 - 5 years of clinical acute care experience
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, Outlook, Teams and One Note
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• High speed internet (no hotspot, DSL or satellite)

Preferred Qualifications
• Experience with case management, discharge planning and patient education for adult acute care
• Managed care experience
• Home Health Care experience
• Telephonic triage experience
• Bachelor's degree
• HCHB experience preferred

Additional Information:
• 20 hours per week
• Saturday and Sunday 10 hours shifts available
• starting pay $34 / hour plus shift differential for evenings and weekends
• Holiday Rotation Required

The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$71,100 - $97,800 per year

Description of Benefits

Humana, Inc. provides medical, dental and vision benefits, 401(k), paid time off, short-term and long-term disability, and life insurance, among others.

About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care.

About CenterWell, a Humana company: CenterWell is focused on whole-person health by addressing physical, emotional and social wellness.

Equal Opportunity Employer: Humana does not discriminate against any employee or applicant based on various factors.

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