Humana

About Humana

 

Job Category:

Member Quality & Financials - Utilization Management

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full Time

Medicare Skilled Nursing Facility Liaison (RN/LVN) - Work at home - Austin, San Antonio, Houston, Dallas or El Paso Texas

Humana - Work At Home, Texas

Posted: 11/14/2018

Description

The Skilled Nursing Facility Liaison represents Humana by making on site visits in the Central, South, West and Panhandle of Texas. The purpose is for data collection, metric presentation, and quality assurance. Three days per week travel is required.

Responsibilities

Role:                   Medicare SNF Liaison Nurse (RN/LPN)

Assignment:     Medicare

Location:           Work at home - Austin, San Antonio, Houston, Dallas or El Paso Texas only (you must live within a commutable distance from one of these greater metropolitan areas)

Assignment Capsule

As the Skilled Nursing Facility Liaison you provide oversight of the SNF facilities in regards to their utilization review and quality outcome metrics and contractual requirements. This is a travel role that will involve day and overnight travel to our SNF facilities across Central, South, West and the Panhandle of Texas

  • Build and maintain new and existing relationships with SNF providers
  • Perform Onsite SNF Facility visits to obtain quality data and confirm facility’s capabilities
  • Document site visit findings in internal databases
  • Act as resource between facility, HSO, and Contracting regarding UM related topics
  • Provide input on Inquiries to join the Humana MA Network
  • Connect SNF personnel to appropriate departments/representatives to resolve SNF level issues
  • Review and Advise UM Staff on SNF related issues or concerns
  • Assists with on-boarding of new post-acute UM team members
  • Attend Humana Corporate SNF Meetings as appropriate
  • Attend SNF outlier rounds when able to provide input or receive input from the UM team
  • Collaborate with UM Team and SNFs regarding escalated operational issues
  • Strategically schedules facility visits for assigned markets in conjunction with Leadership

               

Required Qualifications   

  • You must live within a commutable distance from the airport in one of these greater metropolitan areas:  Austin, San Antonio, Houston, Dallas or El Paso Texas
  • Current License Practical Nurse (LPN or LVN) or Registered Nurse (RN) in Texas
  • Ability to be licensed in multiple states without restrictions
  • Progressive clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
  • Ability to work independently under general instructions and with a team
  • Organized with excellent communication and Emotional Intelligence skills
  • Working knowledge of Microsoft Office
  • Ability to work independently under general instructions and with a team
  • 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 of 10x1 (10mbs download x 1mbs upload) is required
  • Ability to provide a designated workspace; free from distractions with the ability to secure any protected information.
  • 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.
  • Valid driver’s license, car insurance, and access to an automobile
  • This role is a 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.

Preferred Qualifications

  • Health Plan experience
  • Medicare / Medicaid experience while working in a skilled nursing facility
  • Marketing or provider relations experience
  • Previous experience in utilization management, discharge planning and/or home health or rehab
  • Bilingual is a plus

Scheduled Weekly Hours

40

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