Care Manager, Telephonic Nurse

Become a part of our caring community

Shift/availability details:

• Full time 40 hours a week.

• The schedule will be 8 hour shifts, Monday-Friday between the hours of 9am - 5:30pm EST.

• Required weekend coverage every 3rd weekend from 9am - 5:30pm EST. When working weekends, it will allow for off days during the week.

• Required to work a rotating holiday schedule.

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.

Essential Functions:

• 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.

Use your skills to make an impact

Required Experience/Skills:

• 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.

• Must read, write and speak fluent English.

• Current CPR certification.

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Scheduled Weekly Hours

Pay Range

Description of Benefits

About us

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Equal Opportunity Employer

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.