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Care Manager- Telephonic Nurse – FT Evenings & Every Other Weekend

Remote · USA Full-time New today

Overview

Care Manager - Telephonic Nurse - Full-Time Evenings & Every Other Weekend (Remote) Base pay range $71,100.00/yr - $97,800.00/yr Become a part of our caring community and help us put health first. Clinical call center. High volume. Fast paced. Shift Details

  • Full time 40 hours a week.
  • Schedule: 8 hour shifts, Monday-Friday 3:00pm-11:30pm EST.
  • Required weekend coverage every other Saturday & Sunday 3:00pm-11:30pm ET. When working weekends, off-days are provided during the week.
  • Required to work every other holiday.

Responsibilities

  • Supports patients discharged from service or needing post-acute services; navigates healthcare options, post-acute offerings, Medicare coverage, billing issues, and access to healthcare resources.
  • Provides patient options and education using resources and tools; handles location lookups, directions, and customer issues.
  • Determines clinical level of care based on discussion, records, and data; matches needs to service sites or identifies alternatives; acts as patient advocate to ensure timely referrals and maximize admission conversions; follows up on referral and admission outcomes.
  • Maintains awareness of department performance objectives and patient satisfaction goals.
  • Assists in admissions by acting as an ambassador for patients meeting admissions requirements.
  • Focuses on placing the right patient to the right care setting at the right time.
  • Adheres to mandatory training (HIPAA privacy, Business Ethics and Compliance, policies and procedures).
  • Reviews and adheres to all company policies and procedures.
  • Provides education regarding Home Health, Hospice, and Palliative Care Services.
  • Assists with clinical eligibility review for alternate services; participates in special projects and other duties as assigned.

Qualifications

  • Licensed Registered Nurse (RN) with compact state licensure in state of residence with no disciplinary action.
  • 3–5 years of clinical acute care experience.
  • Comprehensive knowledge of Microsoft Office (Word, Excel, Outlook, Teams, OneNote).
  • Passion for contributing to an organization focused on continuously improving consumer experiences.
  • High-speed internet (no hotspot, DSL or satellite).

Preferred Qualifications

  • Experience with case management, discharge planning and patient education for adult acute care.
  • Managed care experience, Home Health Care experience, and telephonic triage experience.
  • Bachelor’s degree; HCHB experience preferred.

Additional Shift Information

  • 40 hours per week.
  • Weekdays after hours and weekends.
  • Holiday coverage.
  • Starting pay: $39.42/hour plus shift differential for evenings and weekends.

Internet and Home/Hybrid Work Requirements

  • Minimum download speed 25 Mbps and upload speed 10 Mbps; wired or wireless connections recommended.
  • Satellite, cellular, and microwave connections require leadership approval.
  • California, Illinois, Montana, or South Dakota residents on home-based work may receive bi-weekly internet expense payments.
  • Provide suitable equipment and maintain a dedicated workspace to protect PHI/HIPAA information.

Benefits

  • Health benefits effective day 1
  • PTO, holidays, and jury duty pay
  • 401(k) with employer match
  • Tuition assistance and scholarships for eligible dependents
  • Caregiver leave and employee charity matching
  • Career development opportunities

Travel: This is a remote position; occasional travel to Humana's offices for training or meetings may be required. Equal Opportunity Employer Humana does not discriminate in employment and complies with applicable laws and affirmative action requirements. It applies to all employment actions including recruitment, hiring, promotion, transfer, demotion, layoff, recall, termination, pay, or other compensation and training opportunities. #J-18808-Ljbffr Salary: USD 71100 - 97800 per year Experience: 3 years required Apply tot his job Apply To this Job

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