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ADAPTED_NOW

Legal Counsel

Through our Humana insurance services and 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. Humana is seeking a Legal Counsel to support its Home Solutions line of business, including CenterWell Home Health, one of the nation’s largest providers of home health care.

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Become a part of our caring community and help us put health first Humana is seeking a Legal Counsel to support its Home Solutions line of business, including CenterWell Home Health, one of the nation’s largest providers of home health care. This position will focus on supporting contracting, payor relations, and revenue cycle management. Support network participating provider contracting efforts across multiple areas including home health, DME, home infusion, and physical therapy Negotiate and resolve disputes with payors Provide strategic counsel regarding operational matters and business initiatives Support the development and implementation of value-based arrangements with payors and other clients Work collaboratively across the Legal team and other teams within Humana, including Compliance and Risk Management Provide leadership with risk assessments, analysis, and proposed mitigation strategies with regard to potential decisions and initiatives Required Qualifications + Juris Doctorate, with licensing in at least one state + At least 3 years of experience in health lawat a law firm or in-house health care organization + Strong legal research, writing, and analytical skills + Ability to clearly communicate complex legal issues and analysis + Ability to work in a complex organization with clients at all levels of the company + Ability to work both independently under general supervision and within a team Preferred Qualifications + Strong understanding of Medicare requirements for health care providers, particularly home health agencies + Demonstrated knowledge of theMedicare Advantage program + Experience drafting and negotiating contractual arrangements, includingpayor and provider network agreements Use your skills to make an impact 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. $138,900 - $191,000 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 07-24-2025 About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. ​ 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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Humana

Legal Counsel – Contracting & Revenue Cycle Management

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Coordinator

Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain Center w/PCI-Resuscitation, Family Center, Heart & Vascular Center, Imaging Services, Neonatal Intensive Care Unit, Orthopedic/Spine Center, Physical Therapy Services, Rehabilitation Center, Stroke Center, Surgical Services, Surgical Weight Loss Center, Network-of-Care Affiliated Physician Practices, and much more. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

Description<h5>Introduction</h5>Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Outcomes Coordinator with HCA Florida Capital Hospital you can be a part of an organization that is devoted to giving back!<h5>Benefits</h5>HCA Florida Capital Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:<ul><li>Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.</li><li>Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.</li><li>Free counseling services and resources for emotional, physical and financial wellbeing </li><li>401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) </li><li>Employee Stock Purchase Plan with 10% off HCA Healthcare stock </li><li>Family support through fertility and family building benefits with Progyny and adoption assistance. </li><li>Referral services for child, elder and pet care, home and auto repair, event planning and more </li><li>Consumer discounts through Abenity and Consumer Discounts </li><li>Retirement readiness, rollover assistance services and preferred banking partnerships </li><li>Education assistance (tuition, student loan, certification support, dependent scholarships) </li><li>Colleague recognition program </li><li>Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) </li><li>Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.</li></ul><a href="https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards" rel="noopener noreferrer nofollow" target="_blank">Learn more about Employee Benefits</a>Note: Eligibility for benefits may vary by location. Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the HCA Florida Capital Hospital family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Outcomes Coordinator to help us reach our goals. Unlock your potential!<h5>Job Summary and Qualifications</h5>The Outcomes Coordinator is responsible for data collection and follow up for multiple quality measures. Abstraction consists of concurrent review of in-house patients for multiple populations; e.g., Heart Failure, Acute Myocardial Infarction, Pneumonia, Surgical Care, Perinatal, Sepsis, Behavioral Health, Stroke and others as added by national quality/regulatory groups. The Outcomes Coordinator proactively interacts with hospital staff and physicians to achieve high performance with recommended care. Incidents of non-compliance are identified promptly, root causes determined and action plans developed to prevent future occurrences.There are additional improvement activities that the Outcomes Coordinator participates in as defined by the needs of the organization and the unique skills of the Outcomes Coordinator. Examples include assisting/leading PI teams, assisting the Infection Control Practitioner with surveillance activities, working with the organization’s committees and teams to effect improvements in care and assuming Administrative COMET user duties.General direction for these activities is provided by the VP of Quality Management; however, this position operates with a high degree of independence and awareness of the organization’s priorities.ESSENTIAL FUNCTIONS:<ul><li>Exhibits responsibility and accountability for assigned work, works independently and interdependently.</li><li>Must balance multiple tasks/projects while meeting organizational standards.</li><li>Must be extremely detail oriented and able to follow through on all assigned tasks.</li><li>Must abstract core measure medical records at or above 85% accuracy level as measured by the quarterly Inter-rater reliability exercise and any CMS Data Validation reviews as the hospital is chosen from random selection.</li><li>Ability to adapt to flexible work schedules and frequent interruptions.</li><li>Demonstrates effective skills in all forms of communication especially with clinical staff and clinical leadership – able to influence care with evidence, guidelines, data and teaching/coaching.</li><li>Develops, implements and maintains quality monitoring and analysis processes that support the Performance Improvement Plan, patient safety and outcome improvement efforts</li><li>Researches applicable evidence based best practices in developing chart abstraction and analytical tools for assigned performance improvement monitors/indicators.</li><li>Uses generated outcomes and process data/reports for further analysis creating final reports for committees that include conclusions, recommendations, actions and follow up.</li><li> Actively participates in or leads Performance Improvement Teams.</li><li>Assists in analyzing occurrences and identifies patterns as evidence for decision making</li><li> Assists with development and implementation of educational programs for employees & medical staff based on trends in performance.</li><li>In accordance with all applicable regulatory standards and in cooperation with the hospital’s educational needs, assists with: design, implementation, coordination and evaluation of educational activities related to learning needs, policies / procedures, standards of care, equipment or knowledge deficits.</li><li>Disseminates information and research related to changes in regulatory requirements and clinical research pertinent</li><li>to potential liability exposures and risk issues.</li><li>Adheres to established hospital and department guidelines and protocols.</li><li>Maintains education and development appropriate for position.</li><li>Other duties as assigned.</li></ul><h6>What qualifications you will need:</h6><ul><li>Associates Degree in Nursing or Diploma in Nursing required</li><li>Bachelor’s Degree in Nursing preferred</li><li>Current FL RN license required or appropriate compact licensure. If compact license held, active FL RN license required within 90 days of hire</li><li>Advanced Practice Registered Nurse license is acceptable for position if current and compliant</li><li>CPHQ certification preferred</li><li>3-5 years clinical experience in a hospital setting required</li></ul>HCA Florida Capital Hospital is your one-stop solution for all your healthcare needs. We are an accredited healthcare facility with over 1,400 skilled employees and 500+ experienced providers. Our 288-bed, acute-care hospital provides 24/7 Emergency Services in Leon and Gadsden Counties. Our facilities include a state-of-the-art Behavioral Health Center, Cancer Center, Chest Pain Center w/PCI-Resuscitation, Family Center, Heart & Vascular Center, Imaging Services, Neonatal Intensive Care Unit, Orthopedic/Spine Center, Physical Therapy Services, Rehabilitation Center, Stroke Center, Surgical Services, Surgical Weight Loss Center, Network-of-Care Affiliated Physician Practices, and much more. Trust us to give you compassionate care and exceptional service. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. <blockquote>"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder</blockquote>Be a part of an organization that invests in you! We are reviewing applications for our Outcomes Coordinator opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!<cite>We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</cite>

HCA Healthcare

Outcomes Coordinator

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