Onsite Care Coordination Nurse

Humana•Lexington, KY

9d•Hybrid

About The Position

Humana is hiring an Onsite Care Coordination Nurse to support members during critical moments in their care journey. The nurse serves as a clinical partner in acute care settings, conducting face-to-face assessments of newly admitted members and leading care coordination to support smooth, safe, and timely transitions from hospital to home. The role involves identifying gaps in care and collaborating with providers and care teams to improve health outcomes and reduce unnecessary readmissions. The position uses a hybrid model, combining in-person work at CommonSpirit–St. Joseph Hospital, 1 St. Joseph Dr., Lexington, Kentucky, with limited remote work for coordination and documentation at the leader’s discretion. Candidates must live within a reasonable commute, preferably a 30–60-minute drive, of the facility. Work is Monday through Friday, 8:00 a.m. to 5:00 p.m. local time, with no required holidays, on-call shifts, or weekends. The role is scheduled for 40 hours per week and may require occasional travel to Humana offices for training or meetings. The role requires a current, unrestricted Kentucky Registered Nurse license, at least three years of recent acute care nursing experience, and experience with discharge planning or care coordination. Candidates must have a valid driver’s license, a dependable automobile, and proof of personal vehicle liability insurance. Required screenings include TB screening and ACHA Level II background clearance, including fingerprinting, as well as any other credentialing and screening required by the assigned facility. For remote documentation, the employee must have a private workspace that protects member PHI/HIPAA information and internet service with at least 25 Mbps download and 10 Mbps upload speeds. The advertised annual base-pay range is $71,100–$97,800, with eligibility for a bonus incentive plan based on company and/or individual performance. Humana offers medical, dental, and vision benefits; a 401(k) retirement savings plan; paid time off and company and personal holidays; paid parental and caregiver leave; short- and long-term disability; life insurance; and other benefits.

Requirements

Current, unrestricted Registered Nurse (RN) license in the state of Kentucky.
Located within a 30–60-minute driving distance of CommonSpirit–St. Joseph Hospital in Lexington, Kentucky.
At least 3 years of recent acute care nursing experience, such as medical-surgical, critical care, heart/lung, skilled nursing, or rehabilitation.
Experience with discharge planning or care coordination in a hospital or health plan setting.
Experience using Microsoft Office applications, including Word, Outlook, and 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, as required by state and company policy.
Completion of other credentialing and screening required by the assigned facility.
Private workspace for remote documentation that protects member PHI/HIPAA information.
Self-provided internet service with at least 25 Mbps download and 10 Mbps upload speed.
Work Monday through Friday, 8:00 a.m. to 5:00 p.m. local time; the position does not require holidays, on-call duty, or weekends.

Nice To Haves

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 skills.
Certification in Care Management or a related specialty.
Knowledge of HEDIS and Stars measures.

Responsibilities

Conduct comprehensive face-to-face assessments of newly admitted members at assigned acute care facilities to evaluate physical, psychosocial, and health needs, and refer members 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, and develop and implement strategies to address them.
Collaborate with attending providers, facility case managers, and other healthcare professionals to ensure timely, coordinated care and effective discharge planning.
Educate members on diagnoses, medications, and preventive measures to promote ongoing wellness and reduce readmission risk.
Complete required documentation accurately and promptly.
Follow infection control, safety, and patient privacy standards.