Clinical Care RN — Transitions & Quality Improvement

Humana Inc; Texas; 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

Job summary

Conviva Senior Primary Care within Humana Inc. seeks an in-center Clinical Care RN to support safe transitions of care, reduce readmissions, and improve Medicare Advantage Stars performance.

You will analyze data from Athena EMR and DataHub, perform post-discharge follow-ups, and educate patients on chronic disease management across DM, HTN, CHF and COPD. The role requires on-site clinic presence, a valid RN license, and 3+ years of nursing experience with TOC or population health.

Qualifications

• Requires ADN or BSN in nursing.
• Active, unrestricted RN license (state-specific).
• 3+ years' clinical nursing experience with transitions of care, quality improvement, managed care, or population health management.

Responsibilities

• Analyze clinical data and trends to identify gaps in care related to Stars and HEDIS.
• Coordinate post-discharge follow-up in alignment with TOC and TCM.
• Outreach via phone, telehealth and in-clinic visits to close care opportunities and educate on preventive care.

Education

Associate's degree in nursing

Bachelor's degree in nursing

Tools

Athena EMR

DataHub

Compass Rose

SalesForce HealthCloud

Microsoft Office Suite

Job description

Conviva Senior Primary Care within Humana Inc. seeks an in-center Clinical Care RN to support safe transitions of care, reduce readmissions, and improve Medicare Advantage Stars performance.

You will analyze data from Athena EMR and DataHub, perform post-discharge follow-ups, and educate patients on chronic disease management across DM, HTN, CHF and COPD. The role requires on-site clinic presence, a valid RN license, and 3+ years of nursing experience with TOC or population health.