Home Care Nurse jobs at UnitedHealth Group

Explore opportunities with Black Stone, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Home and Community Bases Services Aide, you will provide support, assistance with personal hygiene and household functions for an individual to be able to remain in their own home. Primary Responsibilities: * Provide personal care and assist with daily living activities such as bathing, grooming, dressing, ambulation, and medication reminders * Support household tasks, meal preparation, and accompany clients to appointments or errands as needed * Monitor and document client condition, vital signs, and incidents; maintain confidentiality and use EVV system * Ensure a safe environment, operate medical equipment properly, and respond promptly to client needs You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current driver's license, vehicle insurance, and reliable transportation or access to public transit * Current CPR certification * Ability to work flexible hours * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: * 6 months+ of home care experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $24.23 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

The Dental Health Care Provider (HCP) Communications position is accountable for developing dental HCP communications and marketing materials within the Dental organization. The candidate will be responsible for executing all communication initiatives for dental HCPs and the Cigna Dental employees supporting dental networks. The position also includes resolving communication challenges and delivery limitations by sourcing new avenues to deliver messages to HCP's and providing viable recommendations that optimize the dental health care professional experience cost-effectively. Duties and Responsibilities Support the overall dental HCP communication strategy, ensuring that it delivers an efficient and cost-effective competitive positioning for Cigna Dental in the industry. Find new software/communication avenues to effectively communicate with providers. Develop marketing and training video's for HCP's. Manage and execute multiple complex projects with competing timelines. Participate in assigned business projects as the communication subject matter expert with the goal of creating an optimal communication experience for dental HCPs. Attend project meetings to represent Dental HCP Communications. Ensure that Cigna for HCP has updated provider materials. Coordinate and develop quarterly provider newsletter with dental partners. Interact with key matrix partners to drive and execute dental HCP communication strategies and enterprise communication strategies. Coordinate with matrix partners to develop and execute comprehensive internal employee communication training plans and external dental HCP end-to-end communication plans and their distribution for initiatives that affect dental and/or our network of dental HCPs. Ensure all information has been received through the intake system to initiate timely, accurate, quality communication development. Ensure that materials and plans conform to and meet different national and state regulatory requirements and Enterprise Marketing and Branding guidelines. Draft content for internal and external dental HCP communications. Draft content for provider marketing and recruitment materials. Manage communication review/editing process for documents requiring review and secure final sign-off from dental business subject matter experts, project owners, any engaged corporate communications area, compliance, legal, and others as needed. Execute on ad hoc communication requests from business partners Secure accurate mailing lists, assist with distributing mailings, and pull appropriate reporting to ensure the target audience is reached. Interface with internal constituencies (e.g., Network Recruitment, Clinical, Network Operations) to execute communication plans for new initiatives, policy/program changes, and requirements for dental HCPs. This includes providing recommendations relative to the communication strategy and executing Cigna's overall strategic direction and project objectives while remaining within the boundaries of the Dental HCP Communications budget. Work with local market dental network recruitment team representatives to drive market and client-specific communication strategies. Assist in creating and maintaining Standard Operating Procedures for the Dental HCP Communications area. Manage and maintain a centralized location for all approved Dental HCP communications. Manage all reporting and tracking needs for Dental HCP Communications (e.g. budget, communication effectiveness, intake, distribution, etc.) Preferred Qualifications Bachelor's degree preferred. Also open to someone with equivalent experience. 5+ years of managed health care experience in communications. Dental experience strongly preferred. Broad business knowledge of the healthcare services industry. Excellent project management, communication, and presentation skills. Proven ability to work independently and proactively and use critical thinking and problem-solving skills Proven ability to prioritize multiple projects in a fast-paced environment to meet deadlines Strong peer relationship management skills to foster collaboration, value others' perspectives, negotiate, influence, and gain support and buy-in Exceptional writing skills Proficiency in Microsoft Office applications Proficiency in WordPress application Proficiency with Adobe Creative Cloud applications If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities. Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service May support performing service assessments/screenings for members and documenting the member's care needs Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager Provide education on benefits and resources available Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Requires a High School diploma or GED. Requires 1 - 2 years of related experience License/Certification: For Arkansas Total Care plan - Bachelor's degree in social science/health-related field or a high school diploma with at least one (1) year of experience coordinating care for developmentally or intellectually disabled clients or behavioral health clients. This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required Preferred Qualifications: Experience working with members with intellectual and developmental disabilities. This is a field-based role covering Pulaski and Lonoke counties in Arkansas. Pay Range: $17.50 - $27.50 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Pharmacy Clinical Consulting Advisor Internal Job Title - Clinical Account Manager (CAM) Area of Operation - Colorado, Utah, Pacific Northwest As part of Cigna Pharmacy Management, the Pharmacy Sales Advisor is a licensed clinician who serves as the primary pharmacy benefits subject matter expert supporting Cigna Integrated Pharmacy clients within an assigned geographical market(s) and client size band. The Pharmacy Sales Advisor position will be responsible for developing and maintaining relationships with internal stakeholders including the medical sales teams and pharmacy underwriting organization as well as external brokers and consultants. The primary objective of this position is supporting long-term client retention and growth, while achieving Cigna's corporate strategic goals. The Pharmacy Clinical Consulting Advisor also provides pharmacy product and clinical expertise in support of the Medical Sales teams as well as the Pharmacy Implementation organization. This position is responsible for working with the Cigna Medical teams to support the Pharmacy component of an integrated benefit, which typically includes Medical, Pharmacy, and Behavioral. This includes service support, reporting, pricing, and/or other performance guarantees - while working with multiple internal stakeholders at Cigna and Evernorth, as well as external influencers (e.g. consultants, producers and decision makers in the benefits organization or financial and/or C-Suite of our clients). The primary roles of the Pharmacy Clinical Consulting Advisor are: Retain the assigned book of business through proactive portfolio management, including an understanding of available performance guarantees and pricing strategies in order to renew clients and preserve earnings. Participate in client meetings and presentations to review client performance and sell in the suite of pharmacy management programs and solutions that align to Cigna's overall value proposition of lowering total healthcare costs. Act as Pharmacy Sales support for renewals involving consultants. Cultivate meaningful, productive, mutually beneficial relationships internally and externally by gaining the confidence and trust of key stakeholders through honesty, integrity and reliability. Educate and consistently advance the knowledge of pharmacy within the Cigna Medical sales organization. This includes deep dives on our products and services, as well as championing an understanding of the clinical integration points across benefits. Communicate effectively, delivering multi-modal messages that convey a clear understanding of the unique needs of the different audiences requiring interaction. Proactively anticipates communication needs in order to remove ambiguity. Actively participate in finalist meetings for existing business where necessary. Gather and share relevant competitive intelligence in support of retention and new sales efforts. Acts as the clinical subject matter expert supporting medical sales team or the pharmacy Implementation team with escalated pharmacy benefit issues, when necessary. Manages complexity, by analyzing and making sense of a considerable volume of sometimes contradictory information to effectively solve problems. Asks the right questions and attentively listens to others. Stays abreast of clinical pharmacy practice guidelines, including the new drug pipeline, biosimilars, gene therapies, upcoming patent expirations, etc. Additional Responsibilities: Facilitate meetings with clients and brokers to resolve service concerns; act as the escalated issue contact for pharmacy issues when contacted by the medical sales teams. Support detailed ad-hoc analysis of pharmacy claims utilization in order to provide clients with proactive consultation, as well as manage follow-up questions that may arise. Provide executive support for pricing, audit, and contract questions, as requested by internal partners managing these efforts. Translate pharmacy coverage rules and formulary decisions based on Cigna policies with support from Clinical program development partners. Any other tasks as defined by management and/or client needs not named above, as required to support our internal and external stakeholders, clients, and partners. Qualifications: Clinical pharmacy background required; R.Ph. or Pharm.D. 5 years or more of Pharmacy Benefit Management (PBM) experience supporting client expectations Mid to Large Employer account management experience preferred Experience with consultative client management methodologies Proven ability to manage thru a renewal independently with minimal supervision Ability to work through the organizational processes needed to support clients (especially those that are clinical in nature, considering exceptions, etc.) A self-motivated individual displaying ownership, accountability and responsibility Operational understanding and competence with PBM business model Understanding the financial and pricing strategy of PBM Technical skills using all Microsoft programs Ability to travel up to 50% of the time depending on candidate's location with little or no advance notice Competencies: Clinical understanding of PBM space Customer Focus Organizational Agility Network Building Verbal & Written Communication Skills Presentation Skills Financial Acumen Negotiation skills Executive presence If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 107,000 - 178,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. ****NOTE: This is a work-from-home, hybrid remote (up to 50% travel) role that meets virtually and in person with provider groups based in South Carolina to discuss and improve HEDIS performance. Typical daily tasks will include creating/using PowerPoint presentations, creating/exporting reports, and data analysis. Preference will be given to applicants who (1) reside in South Carolina, (2) have a pediatric background, and (3) an active RN license. Additional Details: • Department: MED-Quality Improvement • Business Unit: Absolute Total Care • Schedule: Mon - Fri, 8am - 5 pm CT • Territory: Typically no more than 2 hours from residence.**** Position Purpose: Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding. Supports the development and implementation of quality improvement interventions and audits in relation to plan providers. Delivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements. Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure. Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). Identifies specific practice needs where Centene can provide support. Develops, enhances and maintains provider clinical relationship across product lines. Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards. Ability to travel up to 75% of time to provider offices. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree or equivalent required 3+ years in HEDIS record collection and risk adjustment (coding) required Licenses/Certifications: One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS Registered Health Information Technician (RHIT ) Pay Range: $26.50 - $47.59 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access to services, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are-whether you are working from home, from the field, from our offices, or from somewhere in between-you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone's voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of vacation with pay per year * Aggressive 401K program matching 125% of 6% after year one! Are you caring, Curious and Committed? If so, apply today! Position Responsibilities: The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care. Responsible for the coordination of all the member's needed medical and non-medical services, including functional, social, and environmental services. Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member's identified needs Coordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare. Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member's needs are met. Use your skills to make an impact Required Qualifications Licensed Registered Nurse (RN) in the state of Indiana without restrictions At least one (2) years of clinical experience as a nurse in providing case management or similar health care services (internal note: could be LPN experience if relevant) Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook. Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders. Proven ability of critical thinking, organization, written and verbal communication and problem- solving skills. Ability to manage multiple or competing priorities in a fast-paced environment. Ability to use a variety of electronic information applications/software programs including electronic medical records. Live/Reside in Indiana Preferred Qualifications Bilingual (English/Spanish) or (English/Burmese) Prior nursing home diversion, long-term care, disease management, or case management experience Prior management of Home and Community Based Services waivers (HCBS dual roles only) Prior experience with Medicare & Medicaid recipients Experience working with a geriatric population Experience with health promotion, coaching and wellness Knowledge of community health and social service agencies and additional community resources Additional Information About Humana Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without you This is a place where our nurses influence the C-suite. Where software engineers change lives. Where every associate can build a professional path where they learn and thrive. Through our commitments to wellbeing and work-life balance, we support each associate's personal health, purpose, work style, sense of belonging, and security. Because finding new ways to put health first-for our members and patients and our associates alike-is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with members. On Call-Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's license Proof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limits Access to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first Home Health Aide provides patients with assistance in activities in daily living. The Home Health Aide performs varied activities and moderately complex administrative/operational/customer support assignments. Assists patients within the home with daily living activities. Typically works on semi-routine assignments. The Home Health Aide addresses needs related to disabilities, disease and mental impairment. Helps to manage medications, baths and dresses, takes care of household chores, prepares meals and pays bills. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Use your skills to make an impact Required Qualifications CPR certification Current State License or Registration as a Certified Nursing Assistant (as required by state) This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits Excellent customer service Strong clinical background Strong sense of engagement to be a team player Strong written and verbal communication skills Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications High School Diploma or GED Knowledge of primary care medicine requirements (state specific). Working knowledge of clinical operations 3 - 5 years' experience in telephone triage Electronic Medical Record (EMR) experience Previous RN or Medical Assistant experience Ability to type 25-30 words per minutes accurately Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $37,440 - $43,800 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

RN Tele Travel and Local Contracts This role provides direct clinical patient care with Tenet's in-house contingent Pool, Trusted Resource Associates. Work directly with Tenet on a Travel Contract, Local Contract or PRN. With this in-house assignment you will be part of the contingent workforce pool, yet, a W-2 Tenet employee and wear a Tenet employee badge so you blend in as staff and are not outstanding as a Contractor. You will have direct access to Tenet's hiring managers and, if you ever turn permanent at a Tenet hospital, you will have built up tenure. *For a faster reply, email your resume: ******************************* Job Description and Requirements Specialty: Tele Discipline: RN Start Date: ASAP Duration: 13 Weeks 36 Hours per week Shift: 12 Hours Night Employment Type: Travel Contract and Local Contracts TRA RN Tele: The Registered Nurse will assume responsibility for assessing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. The role is responsible for supervision of staff to which appropriate care is delegated. The role is accountable to support facility CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care. Requirements: - BLS, ACLS, and CPI required for Tele - Must have 2 years of nursing experience with a minimum one-year current experience in your specialty Benefits Weekly pay Housing and Per Diem stipend for Travel Contracts Guaranteed Hours (For Travel Contracts) Preferred Booking Agreement (for Local Contacts) Referral bonus (TRA Active Employees) Education: Required: Graduate of an accredited school of nursing. Preferred: Bachelor's or master's degree. Experience: Required: 2 years of current experience in their specialty. Certifications: Required: Currently licensed, certified, or registered to practice profession as required by law, regulation in state of practice or policy; AHA BLS, and if applicable by corporate policy for unit of hire, AHA ACLS and/or PALS and/or NRP. Physical Demands:

This is a general application which is applicable across all TRA locations and, all RN and Allied Travel and Local contracts. When you receive your offer letter, it will be customized for the specific position you are hired into. With TRA, you will receive greater contract security than with outside agencies while accessing exciting travel and local contracts across the nation. Why Choose TRA? Guaranteed Hours for Travel Contracts Preferred Booking Agreement for Local Contracts Company Matching funds for the 401K Holiday Pay TRA is preferred for all contract assignments within Tenet while receiving the same tenure as Tenet staff. Location: This is a general application link and, you can be hired into any specific position that fits with what location you are looking to be hired into. As mentioned above, your offer letter will be customized and specific for the position you and your Recruiter speak about.

Become a part of our caring community and help us put health first A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their place of residence. This is performed in accordance with physician orders and plan of care under the direction and supervision of the Director of Clinical Services/Clinical Manager. Such care must be provided in accordance with current Federal, State, and local standards, guidelines, and regulations that govern the agency, and as may be required by the Clinical Manager, Director of Nursing, or Administrator to ensure that the highest quality care is always maintained. A Registered Nurse provides services in accordance with the plan of care. Makes the initial evaluation visit and regularly reevaluates the patient's nursing needs. Develop, initiate, and revise the Plan of Care (POC) as necessary to ensure quality and continuity of care. Provides those services requiring substantial specialized nursing skills. Initiates appropriate preventive and rehabilitative nursing procedures. Prepares clinical and progress notes for each patient visit and summaries of care conferences on his/her patients in a timely manner as per Agency policy. Coordinates services. Informs personnel of changes in the condition and needs of the patient. Counsels the patient and family/significant others in meeting nursing and related needs. Participates in and presents in-service programs. Understands and adheres to established Agency policies and procedures. Apply concepts of the agency's infection control plan and universal precaution in coordination/performing client cares activities to protect both patient and staff (OSHA). Processes orders and notifies physician of patient needs and changes in condition. Completes certification/recertification orders and discharge summaries. Determines the amount and type of nursing needed by each individual patient. Refers to Physical Therapist, Speech Language Pathologist, Occupational Therapist and Medical Social Worker those patients requiring their specialized skills. Develops Home Health Aide Care Plan and perform supervisory visits for HHA and LPN/LVN as required. Gives total patient care as needed. Takes on-call duty nights, weekends, and holidays, as assigned. Completes and submits OASIS assessments, reassessments, transfers, resumptions of care, discharges, and significant change in condition in accordance with Agency defined time frames. Appropriately utilizes ICD-10 codes. Use your skills to make an impact Other Duties A Registered Nurse complete appropriate documentation in a timely manner to assure compliance with agency policy. Demonstrate commitment and professional growth by participating in in-service programs and maintaining/improving competency. Maintain the highest standards of professional conduct in relation to information that is confidential in nature. Share information only when the recipient's right to access is clearly established and sharing of such information is in the best interest of the patient. Maintain required licenses, certifications, and mandatory skill updates. Conducts patient care conferences on patients assigned to his/her care. Participates in peer review and Quality Assurance and Performance Improvement as assigned. Required Qualifications Registered Nurse license in the State of Florida CPR certification OSHA Certificate HIV/AIDS Certificate HIPAA Certificate Alzheimer's Certificate Medical Errors Certificate Domestic Violence Certificate Minimum 1+ year(s) professional or personal experience supporting individuals with disabilities, mental illnesses, or challenging behaviors. This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Must have a valid in-state driver's license, provide current registration and insurance, and have a driving record with no more than 2 points within the last 3 years. This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits. Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,200 - $106,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you'll develop and manage care plans that support recovery and help patients get back to the life they love. As a Home Health Registered Nurse, you will: * Provide admission, case management, and follow-up skilled nursing visits for home health patients. * Administer on-going care and case management for each patient, provide necessary follow-up as directed by the Clinical Manager. * Confer with physician in developing the initial plan of treatment based on physician's orders and initial patient assessment. Provide hands-on care, management and evaluation of the care plan and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision. Revise plan in consultation with physician based on ongoing assessments and as required by policy/regulation. * Coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Home Health Aides and external providers). * Report patient care/condition/progress to patient's physician and Clinical Manager on a continuous basis. * Implement patient care plan in conjunction with patient and family to assist them in achieving optimal resolution of needs/problems. * Coordinate/oversee/supervise the work of Home Health Aides, Certified Home Health Aides and Personal Care Workers and provides written personal care instructions/care plan that reflect current plan of care. Monitor the appropriate completion of documentation by home health aides/personal care workers as part of the supervisory/leadership responsibility. * Discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation. * Prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes. Prepare visit/shift reports, updates/summarizes patient records, and confers with other health care disciplines in providing optimum patient care. Use your skills to make an impact Required Experience/Skills: * Diploma, Associate or Bachelor Degree in Nursing * Minimum of one year nursing experience preferred * Strong med surg, ICU, ER, acute experience * Home Health experience a plus * Current and unrestricted Registered Nurse licensure * Current CPR certification * Strong organizational and communication skills * Valid driver's license, auto insurance and reliable transportation. Pay Range * $45.00 - $63.00 - pay per visit/unit * $70,500 - $96,900 per year base pay Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,200 - $106,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you'll develop and manage care plans that support recovery and help patients get back to the life they love. As a Home Health Registered Nurse, you will: * Provide admission, case management, and follow-up skilled nursing visits for home health patients. * Administer on-going care and case management for each patient, provide necessary follow-up as directed by the Clinical Manager. * Confer with physician in developing the initial plan of treatment based on physician's orders and initial patient assessment. Provide hands-on care, management and evaluation of the care plan and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision. Revise plan in consultation with physician based on ongoing assessments and as required by policy/regulation. * Coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Home Health Aides and external providers). * Report patient care/condition/progress to patient's physician and Clinical Manager on a continuous basis. * Implement patient care plan in conjunction with patient and family to assist them in achieving optimal resolution of needs/problems. * Coordinate/oversee/supervise the work of Home Health Aides, Certified Home Health Aides and Personal Care Workers and provides written personal care instructions/care plan that reflect current plan of care. Monitor the appropriate completion of documentation by home health aides/personal care workers as part of the supervisory/leadership responsibility. * Discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation. * Prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes. Prepare visit/shift reports, updates/summarizes patient records, and confers with other health care disciplines in providing optimum patient care. * optimum patient care. Use your skills to make an impact Required Experience/Skills: * Diploma, Associate or Bachelor Degree in Nursing * Minimum of one year nursing experience preferred * Strong med surg, ICU, ER, acute experience * Home Health experience a plus * Current and unrestricted Registered Nurse licensure * Current CPR certification * Strong organizational and communication skills * Valid driver's license, auto insurance and reliable transportation Pay Range * $45.00 - $63.00 - pay per visit/unit * $70,500 - $96,900 per year base pay Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $70,500 - $96,900 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and patterns to the CRC leadership. Provides expert application of evidence based medical necessity review criteria tool. Works collaboratively to review, evaluate and improve the denial appeal process. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Formulates and submits letters of appeal. Creates an effective appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines and coding guidelines, evidence-based medicine, community and national medical management and coding standards and protocols. * Performs reviews of accounts denied for DRG validation and DRG downgrades. * Documents in appropriate denial tracking tool (ACE). Maintains and distributes reports as needed to leadership. * Identifies payment methodology of accounts including Managed Care contract rates, Medicare and State Funded rates, Per-Diems, DRG's, Outlier Payments, and Stop Loss calculations. * Collaborates with Physician Advisors and CRC leadership when documentation-specific areas of concern are identified. * Maintains expertise in clinical areas and current trends in healthcare, inpatient coding and reimbursement methodologies and utilization management specialty areas. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Effectively organizes work priorities * Demonstrates compliance with departmental safety and security policies and practices * Demonstrates critical thinking, analytical skills, and ability to resolve problems * Demonstrates ability to handle multiple assignments and carry out work independently with minimal supervision * Demonstrates quality proficiency by maintaining accuracy at unit standard key performance indicator goals * Possesses excellent written and verbal communication skills * Detail oriented and ability to work independently and in a team setting * Moderate skills in MS Excel and PowerPoint, MS Office * Ability to research difficult coding and documentation issues and follow through to resolution * Ability to work in a virtual setting under minimal supervision * Ability to conduct research regarding state/federal guidelines and applicable regulatory guidelines related to government audit processes Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Includes minimum education, technical training, and/or experience required to perform the job. Education * Minimum Required: * Completion of BSN Degree Program or three years of experience and completion of BSN within five years of employment * RN License in the State of Practice * Current working knowledge of clinical documentation and inpatient coding, discharge planning, utilization management, case management, performance improvement and managed care reimbursement. * Preferred/Desired: * Completion of BSN Degree Program * CCDS certification or inpatient coding certification Experience * Minimum Required: * Three to Five years Clinical RN Experience * Three to Five years of Clinical Documentation Integrity experience * Must have expertise with Interqual and/or MCG Disease Management Ideologies * Strong communication (verbal/written) and interpersonal skills * Knowledge of CMS regulations * Knowledge of inpatient coding guidelines * 1-2 years of current experience with reimbursement methodologies * Preferred/Desired: * Experience preparing appeals for clinical denials related to DRG assignment. * Strong understanding of rules and guidelines, including AHA's Coding Clinics, American Association of Medical Audit Specialists (AAMAS), National Commission on Insurance Guidelines and Medicare Billing Guidelines (CMS), State Funded Billing Regulations (Arizona, California, Nevada) and grievance process; working knowledge of billing codes such as RBRVS, CPT, ICD-10, HCPCS CERTIFICATES, LICENSES, REGISTRATIONS * Required: * RN, * CCDS or other related clinical documentation specialist certification, and/or AHIMA or AAPC Coding Credential CCS, CCA, CIC, CPC or CPMA * Preferred: BSN PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to lift 15-30lbs * Ability to travel approximately 10% of the time; either to client sites, National Insurance Center (NIC) sites, Headquarters, or other designated sites * Ability to sit and work at a computer for a prolonged period of time conducting medical record quality reviews WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc. OTHER * Interaction with facility HIM and / or physician advisors * Must meet the requirements of the Conifer Telecommuting Policy and Procedure As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $56,784.00 - $85,176.00 annually. Compensation depends on location, qualifications, and experience. * Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, life, and business travel insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and patterns to the CRC leadership. Provides expert application of evidence based medical necessity review criteria tool. Works collaboratively to review, evaluate and improve the denial appeal process. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Formulates and submits letters of appeal. Creates an effective appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines and coding guidelines, evidence-based medicine, community and national medical management and coding standards and protocols. * Performs reviews of accounts denied for DRG validation and DRG downgrades. * Documents in appropriate denial tracking tool (ACE). Maintains and distributes reports as needed to leadership. * Identifies payment methodology of accounts including Managed Care contract rates, Medicare and State Funded rates, Per-Diems, DRG's, Outlier Payments, and Stop Loss calculations. * Collaborates with Physician Advisors and CRC leadership when documentation-specific areas of concern are identified. * Maintains expertise in clinical areas and current trends in healthcare, inpatient coding and reimbursement methodologies and utilization management specialty areas. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Effectively organizes work priorities * Demonstrates compliance with departmental safety and security policies and practices * Demonstrates critical thinking, analytical skills, and ability to resolve problems * Demonstrates ability to handle multiple assignments and carry out work independently with minimal supervision * Demonstrates quality proficiency by maintaining accuracy at unit standard key performance indicator goals * Possesses excellent written and verbal communication skills * Detail oriented and ability to work independently and in a team setting * Moderate skills in MS Excel and PowerPoint, MS Office * Ability to research difficult coding and documentation issues and follow through to resolution * Ability to work in a virtual setting under minimal supervision * Ability to conduct research regarding state/federal guidelines and applicable regulatory guidelines related to government audit processes Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Includes minimum education, technical training, and/or experience required to perform the job. Education * Minimum Required: * Completion of BSN Degree Program or three years of experience and completion of BSN within five years of employment * RN License in the State of Practice * Current working knowledge of clinical documentation and inpatient coding, discharge planning, utilization management, case management, performance improvement and managed care reimbursement. * Preferred/Desired: * Completion of BSN Degree Program * CCDS certification or inpatient coding certification Experience * Minimum Required: * Three to Five years Clinical RN Experience * Three to Five years of Clinical Documentation Integrity experience * Must have expertise with Interqual and/or MCG Disease Management Ideologies * Strong communication (verbal/written) and interpersonal skills * Knowledge of CMS regulations * Knowledge of inpatient coding guidelines * 1-2 years of current experience with reimbursement methodologies * Preferred/Desired: * Experience preparing appeals for clinical denials related to DRG assignment. * Strong understanding of rules and guidelines, including AHA's Coding Clinics, American Association of Medical Audit Specialists (AAMAS), National Commission on Insurance Guidelines and Medicare Billing Guidelines (CMS), State Funded Billing Regulations (Arizona, California, Nevada) and grievance process; working knowledge of billing codes such as RBRVS, CPT, ICD-10, HCPCS CERTIFICATES, LICENSES, REGISTRATIONS * Required: * RN, * CCDS or other related clinical documentation specialist certification, and/or AHIMA or AAPC Coding Credential CCS, CCA, CIC, CPC or CPMA * Preferred: BSN PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to lift 15-30lbs * Ability to travel approximately 10% of the time; either to client sites, National Insurance Center (NIC) sites, Headquarters, or other designated sites * Ability to sit and work at a computer for a prolonged period of time conducting medical record quality reviews WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc. OTHER * Interaction with facility HIM and / or physician advisors * Must meet the requirements of the Conifer Telecommuting Policy and Procedure As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $56,784.00 - $85,176.00 annually. Compensation depends on location, qualifications, and experience. * Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, life, and business travel insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

The Transfer Center RN is responsible for coordinating direct admissions and hospital transfers to and from community hospitals with the intent to transfer each patient to an appropriate Tenet hospital. The position works collaboratively to foster relationships with referring facilities, physicians, and hospital staffs in representation of Tenet Healthcare Mission and Values. EDUCATION: Minimum: Education recognized by the State of Florida as qualification for Registered Nurse licensure. Preferred: BSN EXPERIENCE: Minimum of four (4) years clinical experience in an acute care setting, to include Charge Nurse, House Supervisor or other related management experience. REQUIRED CERTIFICATION/LICENSURE/REGISTRATION: Registered Nurse - licensed in the State of Florida. OTHER QUALIFICATIONS: · RN experience in an ER/ Critical Care. · Demonstrated professional leadership skills that include problem resolution capabilities. Demonstrated ability to handle multiple tasks and remain flexible. · Computer literacy in EMR's, Word Processing, and Excel spread sheets. #LI-HB1

Become a part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Use your skills to make an impact Required Qualifications Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action. MUST have Compact License Greater than one year of clinical experience in a RN role in acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. Comprehensive knowledge of Microsoft Word, Outlook and Excel Ability to work independently under general instructions and with a team Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Education: BSN or Bachelor's degree in a related field Three or more years of clinical experience in an acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. Experience as an MDS Coordinator or discharge planner in an acute care setting Previous experience in utilization management/utilization review for a health plan or acute care setting Compact license PLUS a single state RN Licensure in any of the following non-compact states: California, Hawaii, Nevada, Oregon Health Plan experience Previous Medicare/Medicaid Experience a plus Call center or triage experience Bilingual is a plus Additional Information Scheduled Weekly Hours: 40 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Work-At-Home Requirements Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required. Check your internet speed at ***************** A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community and help us put health first This is a Work-At-Home position located in Puerto Rico. You must live in Puerto Rico for this position. The RN Care Manager works in a telephonic environment. They assess and evaluate members' needs and requirements to achieve and maintain an optimal wellness state. Using clinical knowledge, the Care Manager guides members with chronic conditions toward and facilitates interaction with resources appropriate for their care and wellbeing. The Care Manager, Telephonic Nurse's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. You must be fully bilingual in English/Spanish and will be required to pass a test for both languages - Speaking/Reading/Writing included. ***Please submit resume in English. The Care Manager, Telephonic Nurse employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Responsibilities include the following: Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree in Nursing (BSN) Bilingual in English and Spanish (and able to pass language proficiency tests in both languages) Active RN license without restrictions in Puerto Rico Active RN license without restrictions in Florida - if you DO NOT have an active FL RN license, you must have already passed the NCLEX exam. Affiliated with the CPEPR (Colegio de Profesionales de Enfermería de Puerto Rico). Prior clinical experience in adult acute care, skilled nursing, rehabilitation or discharge planning Knowledge in Chronic Condition management (treatment, pharmacological treatment, signs & symptoms, etc.) Diabetes, Hypertension, COPD, Chronic Kidney Disease, etc. Ability to work independently under minimum supervision and with a team. Able to work an 8-hour shift between 8:30 AM - 5:30 PM EST and adjusted for Daylight Savings (Work schedule can be adjusted according to business hours - necessary overtime and/or weekends) Preferred Qualifications Health Plan experience Previous Case Management Experience Call center or triage experience Previous experience managing Medicare members Work-At-Home Requirements To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Humana will provide Work-At-Home employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Language Proficiency Testing Any Humana associate who speaks with a member in a language other than Spanish must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Additional Information As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,300 - $73,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

**Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **Use your skills to make an impact** **Required Qualifications** + ** Licensed Registered Nurse (RN)** in the (appropriate state) with no disciplinary action. + **MUST have Compact License** + Greater than one year of clinical experience in a RN role in acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Ability to work independently under general instructions and with a team + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Education: BSN or Bachelor's degree in a related field + Three or more years of clinical experience in an acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. + Experience as an MDS Coordinator or discharge planner in an acute care setting + Previous experience in utilization management/utilization review for a health plan or acute care setting + Compact license PLUS a single state RN Licensure in any of the following non-compact states: California, Hawaii, Nevada, Oregon + Health Plan experience + Previous Medicare/Medicaid Experience a plus + Call center or triage experience + Bilingual is a plus **Additional Information** + Scheduled Weekly Hours: 40 + Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Work-At-Home Requirements** + Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). + A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required. + Check your internet speed at ***************** + A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Become a part of our caring community and help us put health first Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you'll develop and manage care plans that support recovery and help patients get back to the life they love. Service area: Crawford and Richland Counties As a Home Health RN Case Manager, you will: * Provide admission, case management, and follow-up skilled nursing visits for home health patients. * Administer on-going care and case management for each patient, provide necessary follow-up as directed by the Clinical Manager. * Confer with physician in developing the initial plan of treatment based on physician's orders and initial patient assessment. Provide hands-on care, management, and evaluation of the care plan and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision. Revise plan in consultation with physician based on ongoing assessments and as required by policy/regulation. * Coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Home Health Aides, and external providers). * Report patient care/condition/progress to patient's physician and Clinical Manager on a continuous basis. * Implement patient care plan in conjunction with patient and family to assist them in achieving optimal resolution of needs/problems. * Coordinate/oversee/supervise the work of Home Health Aides, Certified Home Health Aides and Personal Care Workers and provides written personal care instructions/care plan that reflects current plan of care. Monitor the appropriate completion of documentation by home health aides/personal care workers as part of the supervisory/leadership responsibility. * Discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation. * Prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes. Prepare visit/shift reports, updates/summarizes patient records and confers with other health care disciplines in providing optimum patient care Use your skills to make an impact Required Experience/Skills: * Diploma, Associate, or Bachelor Degree in Nursing * A minimum of one year of nursing experience preferred * Strong med surg, ICU, ER, acute experience * Home Health experience is a plus * Current and unrestricted Registered Nurse licensure * Current CPR certification * Strong organizational and communication skills * A valid driver's license, auto insurance, and reliable transportation are required. Pay Range * $45.00 - $63.00 - pay per visit/unit * $70,500 - $96,900 per year base pay Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,200 - $106,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.