Clinical Care RN: Transitions & Quality Improvement

Humana Inc; Seven Oaks (TX); On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Short/long-term disability insurance

Life insurance

Job summary

Humana Inc. seeks a Clinical Care RN in a clinic-based role to support safe transitions of care, reduce avoidable ED visits, and improve Medicare Advantage Stars. You will analyze data, educate patients, and coordinate post-discharge follow-up across CenterWell/Conviva clinics in the Seven Oaks area.

The role emphasizes quality improvement, collaboration with providers, and adherence to CMS standards. In-center work with a Monday–Friday schedule and a strong focus on health equity.

Qualifications

• Must have ADN or BSN degree and active RN license.
• 3+ years of clinical nursing experience with transitions of care or population health.
• Proficient with EMR and data analytics tools (Athena EMR, DataHub, Compass Rose, SF HealthCloud).
• Willing and able to complete and maintain Basic Life Support (BLS).

Responsibilities

• Analyze clinical data and identify gaps in care to improve Stars and HEDIS.
• Coordinate timely post-discharge follow-up per TOC and TCM requirements.
• Conduct outreach via phone, telehealth, and in-clinic visits to close care opportunities.
• Document outreach and outcomes accurately per CMS standards.

Skills

RN license

Athena EMR

DataHub

Data analytics

Motivational interviewing

Bilingual English/Spanish

Education

ADN or BSN degree

Tools

DataHub

Compass Rose

SalesForce HealthCloud

Job description

Humana Inc. seeks a Clinical Care RN in a clinic-based role to support safe transitions of care, reduce avoidable ED visits, and improve Medicare Advantage Stars. You will analyze data, educate patients, and coordinate post-discharge follow-up across CenterWell/Conviva clinics in the Seven Oaks area.

The role emphasizes quality improvement, collaboration with providers, and adherence to CMS standards. In-center work with a Monday–Friday schedule and a strong focus on health equity.