Remote Care Manager — Telephonic RN

Humana Inc; Little Rock (AR); Remote; USD 71,000 - 98,000; Full time

Job summary

Humana Inc's CenterWell Home Health is seeking a Telephonic Nurse Care Manager to support patients transitioning from acute care, coordinating post-acute options, and ensuring continuity of care across home health, hospice, and palliative services.

Reporting to the Manager, Care Management, you will assess clinical needs, educate families, and facilitate timely referrals while protecting privacy and complying with HIPAA.

Qualifications

• Associates Degree required; BSN preferred.
• Compact RN license required; additional state licenses may be needed.
• Minimum 3 years post-acute nursing experience, home health or hospice preferred.
• Knowledge of home health, hospice, and palliative care services.
• Strong communication and empathy over the phone.

Responsibilities

• Be a CenterWell Home Health representative in supporting patients who have been discharged from service or for those who may need post-acute services.
• Navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, and accessing healthcare resources.
• Make clinical level of care determination based on discussion, medical records, and other clinical data; match needs to service site or provide alternatives.
• Maintain awareness of department performance objectives and ensure patient satisfaction goals are met.
• Assist in admissions by acting as an ambassador for patients who meet admissions requirements.
• Focus on placing the right patient to the right care setting at the right time.
• Adhere to company training including HIPAA and compliance programs.
• Review and adhere to all company policies and procedures.
• Provide education regarding Home Health, Hospice, and Palliative Care Services.
• Help with clinical eligibility review for alternate services.
• Participate in special projects and perform other responsibilities.

Skills

Empathetic communication

Verbal and interpersonal communication

Analytical thinking

Home health knowledge

Education

Associates Degree in Nursing

BSN preferred

Job description

Humana Inc's CenterWell Home Health is seeking a Telephonic Nurse Care Manager to support patients transitioning from acute care, coordinating post-acute options, and ensuring continuity of care across home health, hospice, and palliative services.

Reporting to the Manager, Care Management, you will assess clinical needs, educate families, and facilitate timely referrals while protecting privacy and complying with HIPAA.