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Care Manager, Telephonic Nurse
CenterWell Senior Primary Care. Ensure optimal continuity of care for patients transitioning into and out of services .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in post-acute care services, including Home Health, Hospice, and Palliative Care, while effectively advocating for patients and ensuring continuity of care. Proficient in navigating healthcare options, managing referrals, and maintaining compliance with HIPAA and business ethics.
Highest-signal resume keywords
Current RN LicensePost-Acute Nursing ExperienceKnowledge of Home Health ServicesAnalytical and Problem-Solving SkillsExcellent Verbal and Interpersonal Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Post-Acute Care ServicesPatient AdvocacyClinical Eligibility ReviewReferral ManagementPatient Education
Soft Skills
Empathetic CommunicationCustomer ServiceProblem-Solving
Tools & Technologies
Healthcare ResourcesMedical Records
Certifications & Qualifications
Associates DegreeBSN PreferredCompact State RN License
Industry Keywords
Home HealthHospicePalliative CareHIPAA ComplianceBusiness Ethics
About the role
Key responsibilities & impact- Ensure optimal continuity of care for patients transitioning into and out of services
- Serve as a CenterWell Home Health representative for discharged patients and patients 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 locations or provide alternative services
- Advocate for customers throughout the referral process
- Follow up and track referral and admission outcomes
- Support department performance objectives and patient satisfaction goals
- Assist with admissions by serving as a patient ambassador
- Provide education regarding Home Health, Hospice, and Palliative Care Services
- Help with clinical eligibility review for alternate services
- Participate in mandatory HIPAA, Business Ethics and Compliance, and company policy training
- Participate in special projects and perform other assigned responsibilities
- Report directly to the Manager, Care Management
Requirements
What you’ll need- Associates Degree required; BSN preferred
- Current compact state RN license required
- Business needs may require additional state licensures
- At least 3 years post-acute nursing experience
- 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 skills
- Excellent verbal and interpersonal skills
- Ability to communicate with empathy 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 for Monday-Friday 9am-5:30pm EST, every third weekend, rotating holidays, and training outside the advertised shift when needed
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
- Work-from-home arrangement
- Occasional travel to Humana offices for training or meetings