Clinical Care RN: Transitions & Quality Improvement

humana; Florida; Presencial; USD 70.000 - 90.000; Jornada completa

Descripción de la vacante

Humana seeks a Clinical Care RN for clinic-based care coordination to improve transitions of care and patient outcomes. You will balance direct patient education with data-driven quality improvement, aligning with Stars and CMS guidelines.

The role emphasizes proactive outreach, post-discharge follow-up, and cross-functional collaboration to reduce avoidable ED visits and readmissions.

Formación

• ADN or BSN required.
• Active, unrestricted RN license in Florida.
• 3+ years nursing experience with transitions of care, quality improvement, or population health.
• Proficient with Athena EMR, DataHub, Compass Rose, Salesforce HealthCloud, and MS Office.
• Willing to complete Basic Life Support training.

Responsabilidades

• Analyze clinical data from Athena EMR and DataHub to identify gaps in care related to Stars and HEDIS.
• Coordinate post-discharge follow-up for TOC/TCM to prevent readmissions.
• Conduct outreach via phone, telehealth, and in-clinic visits for education on preventive care and chronic disease management.
• Document outreach and outcomes in compliance with CMS standards.
• Collaborate with interdisciplinary teams to implement evidence-based interventions.

Conocimientos

Clinical nursing

Data analysis

Patient education

Educación

Associate's degree in nursing

Bachelor's degree in nursing

Herramientas

Athena EMR

DataHub

Compass Rose

Salesforce HealthCloud

Microsoft Office

Descripción del empleo

Humana seeks a Clinical Care RN for clinic-based care coordination to improve transitions of care and patient outcomes. You will balance direct patient education with data-driven quality improvement, aligning with Stars and CMS guidelines.

The role emphasizes proactive outreach, post-discharge follow-up, and cross-functional collaboration to reduce avoidable ED visits and readmissions.