Humana

About Humana

 

Job Category:

Member Quality & Financials - Utilization Management

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full Time

UM Skilled Nursing Facility Liaison (LPN/RN) - Work at home, SW Texas

Humana - Work At Home, Texas

Posted: 09/18/2018

Description

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

Responsibilities

Role:                  UM SNF Liaison Nurse (LPN/RN)

Assignment:     Medicare

Location:           Work at home, Southwest Texas

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 Experience 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:

The Skilled Nursing Facility Liaison is responsible for approximately 255 Skilled Nursing Facility site visits per year.   The facilities are in the South-West Region of Texas.  Assessing the facility using established guidelines.  This data is then presented to a multidisciplinary team.  Complete facility surveys and enter the survey data into a main data base.  Also responsibilities include addressing issues regarding Skilled Nursing Facilities or members that are in these facilities, issues  related  regarding choice status or requests to join the Humana Skilled Nursing Network, and any Contract related questions for a facility associated with Skilled Nursing Facilities Parent Companies.  Scheduling visits and travel arrangements.

               

Required Qualifications   

  • Bachelor's degree a plus
  • Licensed Registered Nurse (RN) or Licensed Practical Nurse  in the State of Texas with no disciplinary action
  • Ability to travel  50%
  • High level of organizational and scheduling skills
  • 3-5 Year Nursing Utilization Management Nursing
  • Prior clinical experience preferably in , skilled or rehabilitation clinical setting
  • Comprehensive knowledge of Microsoft Word, Outlook and Excel
  • 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.

Preferred Qualifications

  • Health Plan experience
  • Previous Medicare/Medicaid Experience a plus
  • Self Motivated
  • Comfortable presenting information to a group

Scheduled Weekly Hours

40

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