Clinical Care RN: Transitions & Quality Improvement

Humana, Inc.; Florida; On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical, dental & vision benefits

401(k) retirement plan

PTO & holidays

Parental & caregiver leave

Job summary

Humana, Inc. seeks a Clinical Care Nurse (RN) to coordinate transitions of care and support Medicare Advantage quality initiatives in a Florida clinic. The role emphasizes patient education, post-discharge follow-up, and reducing avoidable readmissions through data-driven interventions.

Qualified candidates hold an ADN or BSN and an active Florida RN license, with 3+ years in clinical nursing and experience with Athena EMR and data tools. Bilingual English/Spanish is required.

Qualifications

• RN license in the State of Florida or eligible to obtain one.
• 3+ years' clinical nursing experience with exposure to transitions of care or population health.
• Proficiency with electronic health records (e.g., Athena EMR), data analytics tools, and Microsoft Office.
• Bilingual in English and Spanish with full professional proficiency.
• Willing to maintain Basic Life Support (BLS) training.

Responsibilities

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

Skills

RN License

Bilingual English/Spanish

Athena EMR

DataHub

Compass Rose

SalesForce HealthCloud

Microsoft Office

Quality Improvement

Education

ADN or BSN

Tools

Athena EMR

DataHub

Compass Rose

SalesForce HealthCloud

Microsoft Office

Job description

Humana, Inc. seeks a Clinical Care Nurse (RN) to coordinate transitions of care and support Medicare Advantage quality initiatives in a Florida clinic. The role emphasizes patient education, post-discharge follow-up, and reducing avoidable readmissions through data-driven interventions.

Qualified candidates hold an ADN or BSN and an active Florida RN license, with 3+ years in clinical nursing and experience with Athena EMR and data tools. Bilingual English/Spanish is required.