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Become a part of our caring community and help us put health first Work Schedule: Full-time/40 Hours Position Type: On-site Branch Location: Westbury, NY This is NOT a remote or work-from-home position. This position requires you to sit on-site at our Westbury, NY branch location. The RN Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. This role is a focused on both home health clinical quality assurance and home health clinical operations initiatives. * Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. * Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. * Manages the assignment of caregivers. * Responsible for and oversees the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make the decision to admit patients to service. Assigns appropriate clinicians to a case, as needed. * Instructs and guides clinicians to promote more effective performance and delivery of quality home care services, and is available at all times during operating hours to assist clinicians as appropriate. * Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC). * Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. * Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning. * Works in conjunction with the Branch Director and Company Finance Department to establish location’s revenue and budget goals. * Participates in sales and marketing initiatives. * Supervises all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in accordance with Company policies and procedures. * Handles necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations. * Participates in the interviewing, hiring, training, and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in-service education programs, when needed. Ensures adherence to internal policies and standards. * Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed. * Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through the utilization of Performance Improvement principles. * Responsible for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, for appropriateness of care, delivery, and documentation requirements. * Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. Competently performs patient care assignments and staff management activities. * Provides direct patient care on an infrequent basis and only in times of emergency. * Acts as Branch Director in his/her absence. * Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical documentation meets internal standards. * Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. * Maintains relationships with referral/community sources. Participates in professional organizations and conducts care-related programs. * Performs other related duties as assigned or requested. Use your skills to make an impact Required Experience/Skills: * Graduate of an accredited School of Nursing. * Current state license as a Registered Nurse. * Proof of current CPR. * Valid driver’s license, auto insurance and reliable transportation. * Two years as a Registered Nurse with at least one-year of management experience in a home health, hospice or equivalent environment. * Certified Home health Agency experience is required (NY state requirement) or four years' CHHA experience and six credit hours toward BSN. * Management and people leadership experience, preferred. * OASIS experience, required. OASIS certification (HCS-O, COQS, and/or COS-C), preferred. * Homecare Homebase (HCHB) experience, preferred. * CMS PDGM billing knowledge and/or experience, preferred. Additional Information * Normal Hours of Operation: M-F / 8a-5p (ET) * On-Call Expectation: Rotating on-call shift. * Branch Size: 170 Census (4 STAR rating) * Annual Bonus: Eligible for the annual incentive bonus which has pay-outs both quarterly and annually. 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. $92,600 - $127,400 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. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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") offers competitive benefits that support whole-person well-being. 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)

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Also include management, prioritization, and completion of tasks for executives and their organizational needs.The role additionally supports basic network management tasks (e.Administrative Assistant, Administrative, Salesforce, Assistant, Healthcare, Technology, Management.

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. Among

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Job Description About Fay At Fay, our mission is to make nutrition a foundational pillar of preventative care, improving outcomes, accessibility, and affordability at scale. We're building AI-powered infrastructure to transform preventative healthcare. Think that's bold? We're just getting started. Today, Fay is a three-sided marketplace connecting providers, patients, and payers to revolutionize preventative care delivery. Our b2b2c business-in-a-box solution empowers dietitians to deliver high-quality, affordable nutrition care, helps patients take control of their health, and enables payers to build healthier member populations. Nutrition is our starting point, not the finish line. The platform we're building will expand into new areas of preventative health and wellness as we grow. We're proud to be one of the fastest-growing companies in healthtech, backed by category-defining investors like General Catalyst, Forerunner, 1984, and Goldman Sachs. Ready to leverage AI-driven technology to transform preventative care and make a real-world impact on health? Let's talk. About This Role As Credentialing Manager, you'll own provider enrollment and credentialing operations at Fay — building the systems, processes, and team structures that allow our dietitian network to scale without friction. You'll serve as the in-house expert across a dedicated set of payers and act as the critical bridge between Credentialing and Revenue Cycle Management. This is a player-coach role: you'll set strategy, author SOPs, and own SLAs — while also rolling up your sleeves on escalations and complex payer relationships. You'll report directly to the Head of Credentialing. If you want to build a credentialing function from the ground up at one of the fastest-growing healthtech companies in the country, this role is for you. What You'll Be Doing • Own a dedicated portfolio of 10–15 payers end-to-end. Be the internal subject matter expert on each payer's portal workflows, submission requirements, processing quirks, SLA windows, and escalation contacts. When something breaks, you're the one who knows why and how to fix it., • Manage a team of Provider Enrollment Specialists responsible for application execution. You'll assign and prioritize work, review submissions before they reach payers, and hold the team accountable to quality and throughput standards., • Audit existing credentialing workflows and implement scalable improvements — including technology enablement, process redesign, and smarter resource allocation. You'll drive toward a credentialing operation that can grow without growing headcount proportionally., • Define and own SLAs across the credentialing lifecycle. Track and report on key metrics — turnaround time, application accuracy, denial rates, and resubmission timelines — and proactively surface and resolve bottlenecks before they impact provider go-live dates or revenue., • 3+ years of hands-on provider credentialing and enrollment experience, with at least 2 years in a lead or management capacity — ideally at a health plan, MSO, delegated credentialing entity, or high-growth digital health company, • Deep working knowledge of CAQH ProView, NPDB queries, state licensing and scope-of-practice databases, and the enrollment portals of major commercial and government payers (e.g., Aetna, BCBS, Cigna, UHC, Humana, Medicare/Medicaid), • Demonstrated experience redesigning credentialing workflows — not just executing them — across a high volume of providers and multiple national payers simultaneously, • Experience owning credentialing KPIs and building payer health dashboards with SLA tracking and escalation management, • Strong understanding of the downstream impact of credentialing on claims, billing, and revenue cycle — and how to coordinate across those functions, • Experience credentialing allied health or telehealth providers — particularly dietitians, therapists, or other non-physician specialties, • Familiarity with delegated credentialing agreements and the operational implications of delegated vs. non-delegated payer relationships, • Background at a high-growth startup or digital health company, • Tech-savvy with a strong appetite for automation and systems that enhance speed, accuracy, and scalability Fay is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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