Bilingual RN: Care Transitions & Quality Impact (Clinic)

Humana / CenterWell; United States; Sur place; USD 71 000 - 98 000; Plein temps

Résumé du poste

Humana / CenterWell is seeking a Clinical Care Nurse (RN) to support safe transitions of care, reduce avoidable ED visits, and drive Medicare Advantage Stars and quality performance. This clinic-based role emphasizes patient education, data-driven quality improvement, and collaboration with cross-functional teams to improve outcomes across DM, HTN, CHF, and COPD.

You will work in a center-based environment with daily in-person duties, flexible outreach, and ongoing professional development

Qualifications

• Requires ADN or BSN with active RN license.
• 3+ years of clinical nursing experience with exposure to transitions of care, quality improvement, managed care, or population health management.
• Proficiency with electronic health records (e.g., Athena EMR), data analytics tools (e.g., DataHub, Compass Rose, Salesforce HealthCloud) and Microsoft Office Suite.
• Willing and able to complete and maintain Basic Life Support training.

Responsabilités

• Analyze clinical data and trends in CMS-related measures to identify gaps in care and opportunities for Stars/HEDIS improvements.
• Coordinate post-discharge follow-ups for discharged inpatients, observation, and ED patients.
• Outreach to patients and providers via phone, telehealth, and in-clinic visits to close care opportunities and educate on preventive care and chronic disease management.
• Ensure discharge instructions understanding, medication reconciliation, symptom monitoring, and adherence to follow-up appointments.
• Collaborate with interdisciplinary teams to implement evidence-based interventions and optimize workflows.
• Document outreach, interactions, and outcomes in the medical record, complying with HIPAA and CMS requirements.

Connaissances

RN license

Bilingual EN/ES

Clinical nursing

Athena EMR

DataHub

Compass Rose

Salesforce HealthCloud

Microsoft Office

Basic Life Support

Formation

ADN or BSN

Outils

Athena EMR

DataHub

Compass Rose

Salesforce HealthCloud

Description du poste

Humana / CenterWell is seeking a Clinical Care Nurse (RN) to support safe transitions of care, reduce avoidable ED visits, and drive Medicare Advantage Stars and quality performance. This clinic-based role emphasizes patient education, data-driven quality improvement, and collaboration with cross-functional teams to improve outcomes across DM, HTN, CHF, and COPD.

You will work in a center-based environment with daily in-person duties, flexible outreach, and ongoing professional development