Remote RN: Pre-Authorization & Care Management

Humana; Kentucky; Teletrabalho; USD 71 000 - 98 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Remote work at home

Bonus incentive plan

Competitive benefits

Resumo da oferta

Humana is seeking a Pre-Authorization Nurse to review prior authorization requests for medical necessity and level of care, making independent determinations as needed.

The role requires an active RN license (VA or compact), 2+ years of varied clinical nursing experience, and knowledge of utilization management, discharge planning, or home health. Remote work with occasional travel may apply.

Qualificações

• Active RN license with no disciplinary action (state VA or compact-eligible).
• Minimum 2 years varied clinical nursing experience in acute, skilled, or rehab settings.
• Experience in utilization management, case management, discharge planning or home health/rehab.
• Proficient in MS Office; able to troubleshoot basic technical issues remotely.

Responsabilidades

• Review prior authorization requests for medical necessity and level of care.
• Educate providers on utilization and medical management processes.
• Enter and maintain clinical information across systems and follow guidelines.

Conhecimentos

RN license

Nurse with 2+ years

Utilization management

Case management

Discharge planning

Home health rehab

Microsoft Office (Word/Excel/Power"Pt)

Independent work

Ferramentas

Microsoft Word

Excel

PowerPoint

Descrição da oferta de emprego

Humana is seeking a Pre-Authorization Nurse to review prior authorization requests for medical necessity and level of care, making independent determinations as needed.

The role requires an active RN license (VA or compact), 2+ years of varied clinical nursing experience, and knowledge of utilization management, discharge planning, or home health. Remote work with occasional travel may apply.