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Care Manager, Telephonic Nurse
CenterWell Senior Primary Care. Support patients discharged from CenterWell Home Health services or needing post-acute services .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in post-acute care services, patient advocacy, and healthcare navigation, with a strong focus on home health, hospice, and palliative care. Proficient in clinical eligibility review and maintaining compliance with HIPAA and company policies.
Highest-signal resume keywords
Compact State RN LicensePost-Acute Nursing ExperienceHome Health ExperienceKnowledge of Hospice ServicesAnalytical and Problem-Solving Ability
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical Level of Care DeterminationPatient EducationReferral Process ManagementCompliance TrainingPatient Satisfaction Tracking
Soft Skills
Excellent Verbal CommunicationInterpersonal SkillsEmpathetic CommunicationProblem-Solving Ability
Tools & Technologies
Healthcare Resources NavigationMedical Records Review
Certifications & Qualifications
Associates DegreeBSN Preferred
Industry Keywords
Home HealthHospicePalliative CareMedicare CoverageHIPAA Compliance
About the role
Key responsibilities & impact- Support patients discharged from CenterWell Home Health services or needing post-acute services
- Navigate healthcare options, post-acute care services, Medicare coverage, billing issues, and healthcare resources
- Provide patient options and education regarding sites of service, specialty offerings, post-acute care, and related questions
- Handle customer issues including location lookup, directions, and complaints
- Determine clinical level of care using discussions, medical records, and other clinical data
- Match patient needs to service-site locations or provide alternative services
- Advocate for customers throughout the referral process
- Follow up on and track referral and admission outcomes
- Meet department performance objectives and patient satisfaction goals
- Assist the admissions process as an ambassador for eligible patients
- Place the right patient in the right care setting at the right time
- Complete mandatory HIPAA, business ethics, compliance, and company policy training
- Follow all company policies and procedures
- Educate patients regarding home health, hospice, and palliative care services
- Assist with clinical eligibility review for alternate services
- Participate in special projects and perform other assigned responsibilities
- Report directly to the Manager, Care Management
- Communicate with the CenterWell Home Health clinical team and facilitate patient follow-up
Requirements
What you’ll need- Associates Degree required
- BSN preferred
- Compact state RN license required; additional state licensures may be required based on business needs
- At least 3 years post-acute nursing experience
- Home health or hospice experience preferred
- Knowledge of home health, hospice, and palliative care services
- Ability to learn and master information related to client locations and services
- Analytical and problem-solving ability
- Excellent verbal and interpersonal skills
- Empathetic communication over the phone
- Minimum home internet speed of 25 Mbps download and 10 Mbps upload
- Dedicated work space without ongoing interruptions to protect member PHI/HIPAA information
- Availability to work 40 hours per week over four 10-hour shifts
- Availability for rotating holiday schedule
- Availability to train outside the advertised shift when required
- Occasional travel to Humana offices for training or meetings may be required
Benefits
Comp & perks- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Personal wellness support
- Smart healthcare decision support
- Work-from-home arrangement
- Company-provided training and meetings
- Other benefits and opportunities