Job Title: Nurse Coach

Job Description

As a Nurse Coach, you will utilize your clinical expertise to manage assigned Post-Acute Care patients' transitions from acute care settings to their home settings. This is achieved through telephonic outreach, providing education, coaching, and care coordination to meet the goals of the Post-Acute Care Program, which includes four different health plans. This is a telehealth role where calls automatically answer the next caller in the queue. Candidates will spend 4 hours of their 8-hour shift on the phone.

Responsibilities

• Engage Post-Acute Care patients in the program and administer initial assessments, progress surveys, and discharge surveys to prevent readmissions.
• Perform assessments to reduce readmissions, including educating members about their discharge instructions, ensuring follow-up PCP appointments, medication reconciliation, education on signs and symptoms of their condition, and referrals to community resources and caregivers.
• Collaborate closely with the Post-Acute Care patient's home health agency nurse and physicians to facilitate education and adherence to established healthcare goals and care plans.
• Review utilization information concerning patient care using clinical expertise and match those needs to available care options within the Post-Acute Care Program and specific plan payer requirements.
• Document all interactions, guidance, and interventions in applications.
• Act as a clinical resource for Post-Acute Care Coordinators, assisting in clarifying referral source directives.
• Respond to requests from unlicensed staff regarding scripted clinical questions and provide support.
• Support ongoing reauthorization decisions for Post-Acute Care patients and issue service reauthorizations for home care providers based on medical necessity and payer benefit guidelines.
• Contact referral sources to advise them of referral status and relay updates to the assigned health plan case manager.
• Participate in and contribute to ongoing quality assessment and improvement activities, ensuring data collection for improved analysis and preparing reports as needed.
• Provide evening and weekend coverage as required by business needs.

Essential Skills

• Current nursing license (NY or IL preferred)
• 5 years of nursing experience with 1-2 years of acute nursing experience in areas such as emergency department, intensive care unit, critical care unit, med-surg, etc.
• 2+ years of case management/triage/telehealth experience (telehealth Case Management experience is a plus)
• Strong communication skills for daily phone interactions with members/patients
• Ability to navigate multiple systems/screens
• Telehealth/remote work experience

Additional Skills & Qualifications

• Discharge planning experience
• Experience from managed care
• Prior experience with adult and geriatric nursing
• Friendly and bright personality
• Experience with electronic health records
• Excellent communication, problem-solving, and decision-making skills
• Ability to effectively manage and prioritize tasks
• Demonstrated coachability and history of learning new Electronic Medical Record systems

Work Environment

This is a 100% work-from-home position with equipment provided. Training will last 4-6 weeks (Mon-Fri 8am-5pm EST). Post-training schedule includes 5x8 hour shifts, which must include Monday, Friday, and Saturday, with Tuesday, Wednesday, and/or Thursday off as their 'weekend'. The start time is 8am EST (CST start time is 7am). Candidates must be comfortable with an auto-dialer system and working in a call center environment, including sitting/working at a computer for 8 hours a day. A noise-free, HIPAA-safe environment is required (including a door with a lock and a computer not facing a window).

Pay and Benefits

The pay range for this position is $38.00 - $40.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position will be accepting applications until Jan 30, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.