The job below is no longer available.
You might also like
in Tampa, FL
$38est. per hour HCA Florida Northside Hospital • 5d agoUrgently hiring 19.2 mi Use left and right arrow keys to navigate- $38
est. per hour HCA Florida Northside Hospital • 5d agoUrgently hiring 19.2 mi Use left and right arrow keys to navigate - $13
est. per hour General Dynamics Information Technology • 5d agoUrgently hiring 10 mi Use left and right arrow keys to navigate - General Dynamics Information Technology • 5d ago
Urgently hiring 10 mi Use left and right arrow keys to navigate - $30000 - $100000
Verified per year Assurance • 10d agoUrgently hiring 10 mi Use left and right arrow keys to navigate
Registered Nurse - Clinical Access Team (Work at Home - FLORIDA ) - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | tampa, Florida |
About this job
Role: Clinical Advisor, RN
Assignment: Clinical Access Team
Location: Work-at-Home, Florida
Humana's dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor. Humana's Perfect Service means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members. We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares.
Assignment Capsule
Be a part of our Clinical Space -- as a Clinical Advisor RN on the Clinical Access Team you will engage our members to develop lifelong wellbeing and health.
Humana is seeking a Clinical RN Advisor who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines review criteria.
Telephonically assist members with access to care issues
Facilitate and assess member's clinical requests for access to care
Assess, provide education, research, and provide resolution
Work in a virtual call center environment and handle inbound calls in a call queue
Inbound and outbound calls to members, providers, internal departments working towards resolution
Key Competencies
Builds Trust : Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions.
Accountability : Meets established expectations and takes responsibility for achieving results; encourages others to do the same.
Customer Focus : Connects meaningfully with customers to build emotional engagement and customer advocacy. Simplifies complexity and integrates internal efforts to deliver an optimal customer experience.
Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.
Role Essentials
Active RN license in the state of Florida
Ability to be licensed in multiple states without restrictions
3 years of prior clinical experience preferably in acute care, skilled or rehabilitation clinical setting
Ability to work independently under general instructions and with a team
Role Desirables
BSN or Bachelor's degree in a related field
Health Plan experience
Previous Medicare experience and familiarity with CMS guidelines
Call center experience
Previous experience in case management, discharge planning, home health, rehab, or DME
Bilingual - ability to speak fluently in both English and Spanish
Additional Information
Humana is an organization with careers that change lives---including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
Assignment: Clinical Access Team
Location: Work-at-Home, Florida
Humana's dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor. Humana's Perfect Service means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members. We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares.
Assignment Capsule
Be a part of our Clinical Space -- as a Clinical Advisor RN on the Clinical Access Team you will engage our members to develop lifelong wellbeing and health.
Humana is seeking a Clinical RN Advisor who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines review criteria.
Telephonically assist members with access to care issues
Facilitate and assess member's clinical requests for access to care
Assess, provide education, research, and provide resolution
Work in a virtual call center environment and handle inbound calls in a call queue
Inbound and outbound calls to members, providers, internal departments working towards resolution
Key Competencies
Builds Trust : Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions.
Accountability : Meets established expectations and takes responsibility for achieving results; encourages others to do the same.
Customer Focus : Connects meaningfully with customers to build emotional engagement and customer advocacy. Simplifies complexity and integrates internal efforts to deliver an optimal customer experience.
Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.
Role Essentials
Active RN license in the state of Florida
Ability to be licensed in multiple states without restrictions
3 years of prior clinical experience preferably in acute care, skilled or rehabilitation clinical setting
Ability to work independently under general instructions and with a team
Role Desirables
BSN or Bachelor's degree in a related field
Health Plan experience
Previous Medicare experience and familiarity with CMS guidelines
Call center experience
Previous experience in case management, discharge planning, home health, rehab, or DME
Bilingual - ability to speak fluently in both English and Spanish
Additional Information
Humana is an organization with careers that change lives---including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.