Onsite Care Coordination Nurse

Become a part of our caring community At Humana, we put the health and well-being of our members at the center of everything we do. As an Onsite Care Coordination Nurse, you will play a vital role in supporting members during critical moments in their care journey—serving as a trusted clinical partner within acute care settings. In this role, you’ll provide face-to-face assessments and lead care coordination efforts for newly admitted members, helping ensure smooth, safe, and timely transitions from hospital to home. By identifying gaps in care and collaborating with providers and care teams, you will directly contribute to improving health outcomes and reducing unnecessary readmissions. This is an opportunity for a nurse who is passionate about whole-person care, thrives in an autonomous environment, and values meaningful connections with members and colleagues. The role offers a hybrid work model, combining in-person engagement at assigned facilities with the flexibility to complete coordination and documentation remotely. Key Responsibilities Conduct comprehensive, face to face assessments of newly admitted members at assigned acute care facilities to evaluate physical, psychosocial, and health needs; refer to Humana programs as appropriate. Support and educate members and families on discharge planning from admission through post-discharge, including facilitating follow-up visits with primary care providers. Identify gaps in care, safety concerns, and barriers to discharge; develop and implement strategies to address these issues. Collaborate with attending providers, facility case managers, and other healthcare professionals to ensure timely, coordinated care and effective discharge planning. Provide education on diagnoses, medications, and preventive measures to promote ongoing wellness and reduce risk of readmission. Complete all required documentation accurately and promptly. Maintain adherence to infection control, safety, and patient privacy standards at all times. Onsite Location ** This is an Onsite / Hybrid position at the (Shannon Medical Center, 120 E Harris Ave) located in (San Angelo, TX). The ideal candidate must live within a reasonable commute to the facility preferably no more than a 30-60 minute driving distance to the Onsite location from your home base. ** **This position will work at an Onsite facility and as a Hybrid; will have limited working hours at home based on the leader’s discretion. Use your skills to make an impact Required Qualifications Current, unrestricted Registered Nurse (RN) license in the state of Texas Must be Located within a 30-60 minute driving distance to (Shannon Medical Center, 120 E Harris Ave) from your home base Minimum of 3 years recent acute care nursing experience (e.g., medical-surgical, critical care, heart/lung, skilled nursing, or rehabilitation) Experience with discharge planning or care coordination in a hospital or health plan settings Experience in Microsoft Office applications (Word, Outlook, Excel) and electronic medical records Valid driver’s license, dependable automobile, and proof of personal vehicle liability insurance Preferred Qualifications Bachelor’s degree in Nursing (BSN) Experience in care management, health promotion, or coaching Previous Utilization Management Experience Previous health plan experience Bilingual (English/Spanish) preferred Certification in Care Management or related specialty Knowledge of HEDIS and Stars measures Work Schedule Monday through Friday, 8:00 AM – 5:00 PM local time– This position does not require holidays, on-call or weekends Additional Requirements Participation in Tuberculosis (TB) screening and ACHA Level II background clearance (including fingerprinting), as required by state and company policy Other credentialing and screening as required by assigned facility Must have a private workspace for remote documentation when not in the field 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions 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 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com. 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, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. #J-18808-Ljbffr