Clinical Care RN: Transitions & Quality Improvement

Humana Inc; Deerfield Beach (FL); On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Bonus incentive plan

Competitive benefits

Job summary

Humana Inc/Conviva Senior Primary Care seeks a Clinical Care RN to support transitions of care, reduce readmissions, and drive Medicare Advantage quality metrics. The role emphasizes patient education, data-driven improvements, and collaboration with providers and care teams.

Clinic-based, in-center, 5 days a week with some market travel. Requires ADN/BSN and active RN license; 3+ years’ experience in care transitions and population health preferred.

Qualifications

• Associates or Bachelors in nursing (ADN/BSN).
• Active, unrestricted RN license in applicable state.
• 3+ years in clinical nursing with care-transition or population health exposure.
• Proficiency with EHRs and data analytics tools.
• Willing to complete Basic Life Support training.

Responsibilities

• Analyze clinical data to identify gaps in care related to Stars and HEDIS.
• Coordinate post-discharge follow-up for TOC/TCM requirements.
• Conduct outreach via phone, telehealth, and in-clinic visits for education and care opportunities.
• Document outreach and outcomes per CMS and organizational standards.
• Collaborate with interdisciplinary teams to implement evidence-based interventions.

Skills

RN license

Clinical nursing

EHR proficiency

Data analytics

BLS certification

Education

ADN or BSN

Tools

Athena EMR

DataHub

Compass Rose

Salesforce HealthCloud

Microsoft Office

Job description

Humana Inc/Conviva Senior Primary Care seeks a Clinical Care RN to support transitions of care, reduce readmissions, and drive Medicare Advantage quality metrics. The role emphasizes patient education, data-driven improvements, and collaboration with providers and care teams.

Clinic-based, in-center, 5 days a week with some market travel. Requires ADN/BSN and active RN license; 3+ years’ experience in care transitions and population health preferred.