CenterWell Senior Primary Care

Nurse

• Support safe Transitions of Care, reduce avoidable emergency department utilization, and improve Medicare Advantage Stars and quality performance
• Analyze clinical data and trends from Athena EMR and DataHub to identify care gaps related to Stars, HEDIS, Transitions of Care, and post-hospitalization needs
• Identify recently discharged inpatient, observation, and emergency department patients
• Coordinate timely post-discharge follow-up aligned with TOC and TCM requirements
• Conduct targeted patient and provider outreach by phone, telehealth, and in-clinic visits
• Provide education on preventive care, chronic disease management, and medication management
• Assess discharge-instruction understanding, medication reconciliation, symptom monitoring, and follow-up adherence
• Identify and escalate barriers and collaborate with providers and care teams to prevent readmissions and avoidable ED utilization
• Collaborate with providers, care assistants, center administrators, medical assistants, pharmacy, and quality improvement staff
• Document outreach, clinical interactions, patient encounters, and outcomes accurately and in compliance with organizational and CMS standards
• Participate in center huddles and high-risk rounds
• Participate in quality improvement projects, provider education sessions, and team huddles
• Monitor progress toward Stars and Transitional Care Management goals and develop solutions to improve performance and engagement
• Support clinic operations through provider collaboration, care coordination, and community education
• Coordinate and facilitate in-person Wellness Events focused on closing Stars care opportunities
• Maintain patient confidentiality in accordance with HIPAA
• Follow organizational policies related to safety, infection control, and attendance
• Perform other duties as assigned

Clinical Care Nurse, RN

Operations

• Support pharmacists and patients by triaging inbound calls for Specialty Rx medications
• Perform administrative and initial data-entry tasks, including image scanning
• Receive inbound calls from patients and physicians for prescription clarification
• Enter prescription orders into the system when needed
• Provide telephonic support while ensuring adherence to Specialty Rx operational processes and programs
• Work within defined call-center productivity and quality metrics
• Interpret department policies and methods for completing assignments
• Identify work expectations and quality standards while prioritizing timing
• Follow standard policies and exercise independent discretion where permitted

Specialty Operations Pharmacy Technician

Director

• Oversee clinical operations for the location, including patient care delivery, staff management, documentation quality, and regulatory compliance, working onsite in-office
• Review referrals, determine admission appropriateness, assign clinicians, and ensure Plans of Care meet patient needs and agency standards
• Guide, support, and educate clinicians; assist with goal-setting, care planning, and clinical decision-making
• Remain available during operating hours for clinical support
• Ensure clinical documentation, audits, and billing meet Medicare, payer, and company standards
• Monitor case management quality and outcomes
• Participate in hiring, training, performance evaluation, coaching, and corrective action for clinical staff
• Conduct ongoing staff education based on documentation review, utilization review findings, and performance improvement data
• Coordinate communication among physicians, team members, and caregivers to support care coordination, discharge planning, and outcome achievement
• Participate in quality improvement, data tracking, budgeting activities, marketing initiatives, and community relationship development
• Provide direct patient care on a limited basis in exceptional or unplanned circumstances
• Act as Branch Director in their absence
• Perform additional tasks to support clinical operations and organizational goals

Director of Patient Services

• Integrate programs developed to improve overall health outcomes, focusing on prescription drugs
• Oversee medication therapy and strategy for comprehensive medication reviews
• Optimize prescription drug use for patients taking multiple medications
• Promote health awareness through Rx education and targeted quarterly campaigns
• Place outbound calls to confirm patients are taking drugs and provide counseling
• Apply professional concepts, standards, regulations, strategies, and operating standards
• Make decisions regarding own work approach and priorities while following direction
• Travel occasionally to Humana offices for training or meetings if required
• Document and manage information using EHR systems

LPN, RX Clinical Program Professional

• Provide skilled nursing care to patients in their homes, including administering medications, performing wound care, and conducting patient assessments
• Develop and implement individualized care plans with physicians and healthcare professionals
• Monitor patients' conditions and report changes
• Educate patients and families on disease management, medication, and treatment options
• Maintain accurate patient-care records and coordinate with healthcare professionals
• Report patient care and condition progress to the patient's physician and Clinical Manager
• Oversee Home Health Aides and monitor completion of documentation

Home Health Registered Nurse

Physician

• Deliver comprehensive outpatient care to adult and senior patients
• Maintain accurate medical records and documentation
• Diagnose and manage moderately to complex medical conditions
• Coordinate referrals and collaborate with specialists
• Participate in clinical quality improvement projects
• Work with interdisciplinary teams to ensure holistic care
• Contribute to projects and innovations in care delivery
• Work on-site at both the Brownsville and Harlingen clinics
• Report to the Associate Medical Director for the Rio Grande Valley

Primary Care Physician

Account Manager

• Define the sales strategy for multiple lines of business targeting specific markets
• Develop and execute growth strategies for CenterWell's MSO/IPA network
• Engage independent primary care practices on CenterWell's MSO/IPA offering in the Seattle and Salt Lake City markets
• Recruit providers into CenterWell IPA Solutions and drive membership growth
• Serve as subject matter expert on CenterWell's MSO/IPA product portfolio
• Develop provider and membership growth strategies
• Analyze local market competitive landscapes and impacts on CenterWell's product portfolio
• Leverage quantitative and qualitative input to drive channel growth
• Recognize trends that enhance product offerings
• Facilitate complex negotiations and advance agreements with new provider partners
• Provide national and local market leadership teams with reporting and growth insights
• Collaborate on program design, contracting efforts and capital deployment
• Develop provider partnerships focused on success in a value-based setting and improved patient health outcomes
• Report to the Associate Director, Channel Development
• Travel occasionally to Humana offices for training or meetings

Market Growth Lead – Provider Partnerships

• Provide outpatient primary care services to adult and geriatric populations
• Maintain accurate and up-to-date medical histories and records
• Manage moderately complex to complex medical conditions
• Refer patients to specialists
• Collaborate with interdisciplinary teams to ensure comprehensive care
• Contribute to departmental strategy and quality improvement programs
• Work onsite in outpatient clinics
• Cover three outpatient clinic locations: CenterWell Redbird in Dallas, DeSoto, and Grand Prairie
• Provide care during clinic hours Monday–Friday, 8:00 AM–5:00 PM

Part-Time Primary Care Physician

Speech Language Pathologist

• Evaluate, direct and provide speech/language pathology service to patients in the home or facility
• Participate in the development and periodic review of the Plan of Treatment and Plan of Care
• Assess and treat disorders of speech, voice, language, hearing and swallowing
• Administer and interpret diagnostic tests and therapeutic treatments, including audiologic screening
• Observe, record and report changes in patients' conditions and treatment responses
• Instruct and train patients in the use of alternative communication systems when appropriate
• Provide counsel and instruction to patients, families and healthcare staff
• Maintain and submit required documentation
• Prepare written reports of evaluations, visits, summaries, care plans, care coordination activities and progress reports
• Participate in care coordination and discharge planning
• Maintain confidentiality and share information only when authorized and in the patient's best interests

• Report to the Market Executive of Operations
• Manage daily branch operations and ensure operational efficiencies, quality of patient care, regulatory compliance, business development, patient base growth, goal achievement, and people management/development
• Manage branch and clinical staff
• Ensure compliance with Federal, State, and local laws regarding certification and licensure
• Lead long-range planning, fiscal viability, and quality of care
• Recruit, interview, and hire staff
• Monitor quality care and organizational performance
• Coordinate activities across disciplines and ensure continuity, appropriateness, and quality of services
• Develop, plan, implement, analyze, and organize branch operations
• Provide guidance and support to Clinical Managers for delivery of care
• Establish branch revenue and budget goals with operations and finance leadership
• Maintain safe, productive, and organized office operations
• Conduct quarterly quality improvement committee meetings and review patient satisfaction data
• Follow up on negative patient satisfaction surveys and referral-source visits
• Communicate direction and implement programs and protocols
• Partner with Sales Directors and Account Managers to meet admission goals
• Participate in sales and marketing initiatives

Branch Director, Home Health

• Complete regular chart reviews and coordinate monthly meetings
• Serve as a resource for advanced practice providers to ensure quality patient care
• Collaborate with clinical leaders regarding quality of care, outcome data, procedures, and records issues
• Partner with Nurse Practitioners to bridge gaps in care
• Report directly to the Associate Director

Virtual Physician Collaborator

Pharmacist

• Enter prescriptions in ePost sent by physicians for further processing by other departments
• Perform varied, moderately complex administrative, operational, and customer support assignments
• Perform computations
• Meet or exceed department production and quality goals/metrics
• Interpret area/department policies and methods to complete assignments
• Work within defined parameters to identify work expectations and quality standards
• Work under minimal direction with independent discretion

Pharmacy Technician – Item Entry

Representative

• Address incoming telephone, digital, or written inquiries
• Perform basic administrative, clerical, operational, customer support, and computational tasks
• Address customer needs, including complex benefit questions
• Resolve customer issues and educate members
• Record details of inquiries, comments, complaints, transactions, and interactions
• Take action according to recorded customer interactions
• Escalate unresolved and pending customer grievances
• Work within defined parameters, quality standards, priorities, timing, policies, and guidelines under close supervision

Inbound Contacts Representative

Therapist

• Administer the physical therapy treatment plan to patients in their homes as developed by the Physical Therapist
• Administer active and passive manual therapeutic exercises, therapeutic massage, traction, heat, light, cold, water, and electrical modalities
• Document client records and submit clinical documentation to the office weekly
• Attend educational meetings and coordinate department in-services
• Notify the Physical Therapist or Branch Director about equipment failures, supply shortages, or staff/client changes
• Apply infection control concepts and universal precautions during patient care
• Help home-health patients regain strength, mobility, and independence through personalized care
• Report to the Clinical Manager

Home Health Physical Therapist Assistant

• Provide skilled nursing care to patients in their homes, including administering medications, performing wound care, and conducting patient assessments
• Develop and implement individualized care plans with physicians and other healthcare professionals
• Monitor patients' conditions and report changes
• Educate patients and families on disease management, medication, and treatment options
• Maintain accurate patient care records and coordinate with healthcare professionals
• Report patient care and condition progress to the patient's physician and Clinical Manager
• Oversee Home Health Aides and monitor completion of documentation
• Support patients' recovery, rehabilitation, and independence in their homes