Care Manager- Telephonic Nurse Part Time

humana; United States; Remote; USD 71,000 - 98,000; Part time

Benefits offered by this job

Remote work option

Competitive benefits

Job summary

Humana is seeking a Telephonic Registered Nurse Care Manager to work from home part-time (20 hours/week). The role supports patients transitioning into and out of services, guiding post-acute options and coordinating care with the clinical team.

You will help determine appropriate care settings and assist with admissions while maintaining HIPAA and compliance standards. The position requires strong communication skills, clinical knowledge of home health, hospice, and palliative care, and the

Qualifications

• Associates degree required; BSN preferred.
• Compact state RN license required.
• At least 3 years post-acute nursing experience.
• Knowledge of home health, hospice, and palliative care services.
• Excellent verbal and interpersonal skills; empathy over the phone.

Responsibilities

• Be a CenterWell Home Health representative assisting patients discharged from service or needing post-acute services.
• Provide patient options and education using multiple tools; handle location lookups and inquiries.
• Determine level of care based on discussions, records, and clinical data; match to service sites or alternatives.
• Assist in admissions as an ambassador for patients meeting admission requirements; focus on appropriate placement.

Skills

Empathy over the phone

Excellent verbal and interpersonal

Education

Associates Degree

BSN preferred

Job description

Become a part of our caring community

Shift/Availability

This is a part time position scheduled for 20 hours a week. The schedule is Saturday and Sunday from 10am-8:30pm EST. Training requirements: Able to train on weekdays (Monday-Friday) in the evenings and weekends (Saturday & Sunday) during the day and/or in the evening. Required to work a rotating holiday schedule.

In this position you will work-from-home in a remote setting as a telephonic Registered Nurse.

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

Requirements

• 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.

Work at Home Requirements

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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

20

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. 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. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and