Care Coordination Nurse

• Conduct comprehensive face-to-face assessments of newly admitted members at assigned acute care facilities
• Evaluate members’ physical, psychosocial, and health needs and refer them to Humana programs as appropriate
• Support and educate members and families on discharge planning from admission through post-discharge
• Facilitate follow-up visits with primary care providers
• Identify gaps in care, safety concerns, and barriers to discharge
• Develop and implement strategies to address care and discharge barriers
• Collaborate with attending providers, facility case managers, and other healthcare professionals
• Provide education on diagnoses, medications, and preventive measures
• Complete required documentation accurately and promptly
• Maintain infection-control, safety, and patient-privacy standards
• Work onsite at Advocate South Suburban Hospital with limited remote hours for coordination and documentation
• Travel occasionally to Humana offices for training or meetings

• Current, unrestricted Registered Nurse (RN) license in the state of Illinois
• Must live within a 30–60 minute driving distance of Advocate South Suburban Hospital, 17800 S Kedzie Ave, from the home base
• Minimum of 3 years recent acute care nursing experience
• Experience with discharge planning or care coordination in a hospital or health plan setting
• Experience with Microsoft Office applications (Word, Outlook, Excel) and electronic medical records
• Valid driver’s license, dependable automobile, and proof of personal vehicle liability insurance
• Participation in TB screening and ACHA Level II background clearance, including fingerprinting
• Other credentialing and screening as required by the assigned facility
• Private workspace for remote documentation
• Minimum home internet speed of 25 Mbps download and 10 Mbps upload
• Dedicated workspace without ongoing interruptions to protect PHI/HIPAA information
• Bachelor’s degree in Nursing (BSN) preferred
• Care management, health promotion, or coaching experience preferred
• Utilization Management experience preferred
• Health plan experience preferred
• Bilingual English/Spanish preferred
• Certification in Care Management or related specialty preferred
• Knowledge of HEDIS and Stars measures preferred

Demonstrates expertise in conducting comprehensive assessments, discharge planning, and care coordination within acute care settings. Proficient in collaborating with healthcare professionals and educating members on health needs while maintaining compliance with safety and privacy standards.

• Registered Nurse (RN) License
• Acute Care Nursing Experience
• Discharge Planning Experience
• Microsoft Office Applications
• Bilingual English/Spanish

• Comprehensive Assessments
• Care Coordination
• Discharge Planning
• Documentation Accuracy
• Infection Control Standards
• Health Needs Evaluation
• Patient Education
• HEDIS Knowledge
• Stars Measures Knowledge

• Collaboration
• Communication
• Problem-Solving
• Patient Advocacy

• Registered Nurse (RN) License
• Certification in Care Management

• Acute Care Facilities
• Health Plan Experience
• Care Management
• Health Promotion
• Utilization Management
• TB Screening
• ACHA Level II Background Clearance
• PHI/HIPAA Compliance

• Electronic Medical Records
• Microsoft Word
• Microsoft Outlook
• Microsoft Excel