Field Care Manager Nurse

CenterWell Senior Primary Care; Louisville (KY); Hybride; USD 71 000 - 98 000; Plein temps

Résumé du poste

CenterWell Senior Primary Care is seeking a Registered Nurse with home health experience to develop and oversee Medicare/Medicaid Stars programs. You will collaborate with market leadership and the quality improvement team to boost patient outcomes.

The role requires travel to members’ residences (within 30–40 miles), strong communication skills, and experience with EMR systems. A BSN is preferred, and a full-time schedule is expected in the Louisville area.

Qualifications

• Active RN license with 2+ years in home case/care management
• Experience with adult population care
• Knowledge of community resources and health services
• Ability to travel 30–40 miles to member residences
• Strong communication and interpersonal skills
• Ability to work with minimal supervision
• Proficient in EMR and MS Office applications
• Flexible, full-time schedule (40 hours)
• Must have a valid driver’s license and auto insurance
• Privacy requirements and TB screening adherence

Responsabilités

• Develop and oversee Medicare/Medicaid Stars program initiatives
• Collaborate with market leadership and quality improvement teams
• Improve patient outcomes through program design and implementation
• Coordinate with quality coordinators and center teams
• Address provider performance, member experience, and market growth
• Maintain documentation and coding accuracy
• Support data sharing and operational efficiency

Connaissances

Home health care

Nursing assessment

Care coordination

Communication skills

Travel to member homes

Electronic medical records

Microsoft Word/Outlook/Excel

Formation

BSN preferred

Outils

EMR systems

MS Office

Description du poste

Become a part of our caring community

The Stars Improvement, Clinical Professional 2 responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Become a part of our caring community

The Stars Improvement, Clinical Professional 2 responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Stars Improvement Clinical Professional (RN) collaborates with market leadership, and quality improvement team to develop and implement programs designed to increase patient outcomes.

Work is performed within the associate's assigned center locations and in collaboration with existing Quality Improvement Coordinators and Professionals and in close partnership with market and center teams.

The Stars Improvement, Clinical Professional (RN) represents the scope of provider relationships across the following areas:

• Quality/clinical management and population health
• HEDIS and Stars performance
• Operational improvements
• Financial performance and incentive programs
• Data sharing and connectivity
• Documentation and coding
• Additional areas related to provider performance, member experience, market growth, provider experience and operational excellence

Required Qualifications

Use your skills to make an impact

• Registered Nurse with 2 years of experience of in home case/care management
• Experience working with the adult population
• Knowledge of community health and social service agencies and additional community resources
• Ability to travel to member's residence within 30 to 40 miles
• Exceptional communication and interpersonal skills with the ability to quickly build rapport
• Ability to work with minimal supervision within the role and scope
• Ability to use a variety of electronic information applications/software programs including electronic medical records
• Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel
• Excellent keyboard and web navigation skills
• Ability to work a full-time (40 hours minimum) flexible work schedule
• This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher
• Must have a separate room with a locked door that can be used as a home office to ensure continuous privacy while you work
• Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana At Home systems if 5Mx1M
• This role is considered patient facing and is part of Humana At Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• Valid driver's license, car insurance, and access to an automobile
• Associates working in the State of Florida will need ACHA Level II Background clearance
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• BSN
• 3-5 years of in home assessment and care coordination experience
• Experience with health promotion, coaching and wellness
• Previous managed care experience
• Bilingual — English, Spanish
• Certification in Case Management
• Motivational Interviewing Certification and/or knowledge

Additional Information

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$71,100 - $97,800 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.