RN Care Transitions & Quality Champion

Humana Inc; United States; On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement plan

Paid time off and holidays

Life insurance

Job summary

Humana CenterWell Senior Primary Care seeks a Clinical Care Nurse (RN) to improve patient outcomes in a clinic setting. You will support safe transitions of care, reduce avoidable ED visits, and drive Medicare Advantage Stars and quality performance.

The role involves patient education, post-discharge follow-up, and collaboration with an interdisciplinary team across centers. In-center duties require daily commuting within the market and adherence to HIPAA and CMS standards.

Qualifications

• RN with licensure in the applicable state.
• 3+ years of clinical nursing experience with exposure to transitions of care or quality improvement.

Responsibilities

• Analyze clinical data to identify gaps related to Stars/HEDIS and TOC.
• Coordinate post-discharge follow-up to prevent readmissions.
• Educate patients and providers on preventive care and chronic disease management.
• Ensure discharge instructions and medication reconciliation are understood.
• Collaborate with interdisciplinary teams to implement evidence-based interventions.
• Document outreach and outcomes accurately per CMS standards.
• Participate in quality improvement and provider education sessions.

Skills

Clinical nursing

Data analysis

Patient education

Education

ADN or BSN

Tools

Athena EMR

DataHub

Compass Rose

Salesforce HealthCloud

Microsoft Office

Job description

Humana CenterWell Senior Primary Care seeks a Clinical Care Nurse (RN) to improve patient outcomes in a clinic setting. You will support safe transitions of care, reduce avoidable ED visits, and drive Medicare Advantage Stars and quality performance.

The role involves patient education, post-discharge follow-up, and collaboration with an interdisciplinary team across centers. In-center duties require daily commuting within the market and adherence to HIPAA and CMS standards.