Georgia Clinical Care RN: Transitions & Quality

Humana, Inc.; Morrow (GA); On-site; USD 71,000 - 98,000; Full time

Job summary

Humana, Inc. is seeking a Clinic-based Clinical Care Nurse (RN) in Georgia to support safe transitions of care, reduce avoidable readmissions, and contribute to Medicare Advantage Stars and quality performance.

In this role you will analyze clinical data using Athena EMR and DataHub, coordinate post-discharge follow-up, educate patients, and collaborate with providers and care teams to close care gaps and improve patient outcomes across transitions of care.

Qualifications

• ADN or BSN required
• Active RN license in GA
• 3+ years in transitions of care or population health
• Experience with Athena EMR and data tools

Responsibilities

• Analyze clinical data and trends to identify gaps in care related to Stars and HEDIS measures and Transitions of Care.
• Proactively identify recently discharged patients and coordinate timely post-discharge follow-up.
• Conduct outreach via phone, telehealth and in-clinic visits to close care opportunities and educate patients on preventive care and chronic disease management.
• Document patient encounters accurately and timely in the medical record and CMS guidelines.
• Collaborate with interdisciplinary teams to implement evidence-based interventions and optimize workflows.

Skills

Clinical nursing

Data analysis

Patient education

Communication

Education

ADN or BSN

Tools

Athena EMR

DataHub

SalesForce HealthCloud

Microsoft Office

Job description

Humana, Inc. is seeking a Clinic-based Clinical Care Nurse (RN) in Georgia to support safe transitions of care, reduce avoidable readmissions, and contribute to Medicare Advantage Stars and quality performance.

In this role you will analyze clinical data using Athena EMR and DataHub, coordinate post-discharge follow-up, educate patients, and collaborate with providers and care teams to close care gaps and improve patient outcomes across transitions of care.