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As a LPN, you will:
Assess patient health problems and needsTake vital signsAdminister medicationDevelop and implement nursing care plansMaintain electronic medical recordsAdvise patients on health maintenance and disease prevention or provide case managementRequired Qualifications
Current licensure as an LPN in South CarolinaThis role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.At least 2 years of experience as a LPN.Preferred Qualifications
BilingualPhlebotomy experienceExperience with Electronic Medical RecordsExperience with HEDISScheduled Weekly Hours
40Pay 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.
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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Read LessJob Functions
The LPN/LVN assesses patient health problems and needs.You will take vital signs, administer medication, develop, and implement nursing care plans, and maintain medical records.You will advise patients on health maintenance and disease prevention or provide case management.You will need to understand own work area professional concepts/standards, regulations, strategies, and operating standards.Required Qualifications
You will have a current licensure as an LPN or LVNThis role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.Preferred Qualifications
Bilingual in English and SpanishHands-on professionalPhlebotomy experienceExperience with Electronic Medical RecordsExperience with HEDISKnowledge of primary care medicine requirements (state specific).Working knowledge of clinical operationsScheduled Weekly Hours
40Pay 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.
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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Read LessPopulation Health & Care Transitions
Lead proactive identification and outreach for high-risk patients, with emphasis on:
Out-of-network hospital admissions
Patients at risk for inpatient, observation, or ED utilization
ESRD and advanced CKD (Stages 4-5) populations
Provide end-to-end transitions of care support, including inpatient, ED, observation, and post-acute transitions.
Conduct goals of care conversations and provide support for palliative and hospice care discussions
Conduct post-discharge follow-up aligned with Transitional Care Management (TCM) requirements to reduce avoidable readmissions and ED returns.
Out-of-Network Hospitalization Management
Identify and track OON admissions using EMR and utilization data.
Partner with providers, care teams, and leadership to intervene early and address drivers of OON utilization.
Support care continuity post-discharge, including medication reconciliation, follow-up scheduling, and specialist coordination.
Escalate systemic barriers impacting network alignment, access, or care coordination to the MCMO and market leadership.
Provide education to patients on in-network hospitals and call us first services
Kidney Care Navigation & Chronic Disease Support
Serve as a clinical navigator for patients with ESRD and CKD Stages 4-5.
Collaborate with dialysis centers to ensure completion and submission of CMS Form 2728 for ESRD patients
Conduct comprehensive assessments to understand clinical, social, and system-level needs.
Collaborate with PCPs, nephrologists, and interdisciplinary teams to support individualized care plans.
Educate patients and caregivers on disease progression, treatment options, self-management, and care planning.
Quality, Data & Value-Based Performance
Analyze clinical and utilization data to identify trends and care gaps related to:
Medicare Advantage Stars
HEDIS
Utilization and avoidable admissions
Prioritize interventions that improve quality performance, affordability, and patient outcomes.
Support accurate documentation, coding, and care gap closure in partnership with providers and clinic teams.
Collaboration & Program Development
Work closely with physicians, clinic staff, pharmacy, care assistants, and quality teams to implement evidence-based interventions.
Participate in huddles, high-risk rounds, and case conferences.
Contribute to the development and refinement of population health workflows, particularly for kidney care and hospitalization management.
Provide informal education and clinical support to care teams related to population health priorities
Coordinate with Integrated Home Care Program and CW Home Health to reduce unnecessary hospital utilization
Documentation & Compliance
Document patient outreach, assessments, interventions, and outcomes accurately and timely in the medical record.
Ensure compliance with HIPAA, CMS requirements, and organizational policies.
Maintain confidentiality, safety standards, and professional conduct.
Required Qualifications
Active, unrestricted Registered Nurse (RN) license in the state of practice.
Associate's or Bachelor's degree in Nursing (ADN or BSN).
3+ years of clinical nursing experience, with exposure to one or more of the following:
Transitions of care
Population health or care management
Chronic disease management
Hospital, post-acute, or managed care environments
Strong clinical judgment, critical thinking, and care coordination skills.
Proficiency with EMR systems and basic data analysis tools.
Ability to work independently while collaborating effectively across teams.
Preferred Qualifications
5+ years of experience in population health, care management, nephrology, dialysis, or complex care navigation.
Experience with ESRD and advanced CKD populations.
Experience with utilization management and hospital transitions, including post-discharge follow-up.
Knowledge of Medicare Advantage, Stars, HEDIS, and value-based care models.
Certification in Case Management (CCM) and/or Nephrology Nursing (CNN).
Experience in program development or workflow design.
Bilingual proficiency (market dependent).
Scheduled Weekly Hours
40Pay 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.
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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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