Remote RN Utilization Management Leader

Humana; Frankfort (KY); On-site; USD 95,000 - 131,000; Full time

Benefits offered by this job

Bonus incentive plan

Work from home

Job summary

Humana is seeking a Manager, Utilization Management Nursing to lead coordination and interpretation of medical services and benefit determinations in a remote, home‑based role. You will apply advanced nursing knowledge, guide teams, and collaborate across departments to ensure compliant and efficient patient care.

Candidates must be an active RN (Virginia or eNLC) with 2+ years of leadership and clinical experience; proficiency in MS Office; ability to work independently in a remote setting;

Qualifications

• Active RN license (Virginia or eNLC) without disciplinary action.
• Minimum 2 years of team or project lead experience.
• Minimum 2 years of clinical experience, preferably in acute care/rehab.
• Intermediate to advanced MS Office skills and multi‑system navigation.

Responsibilities

• Coordinate, document, and communicate medical services and benefit determinations.
• Lead cross‑functional collaboration and briefings within the department.
• Apply clinical knowledge and critical thinking to ensure appropriate care decisions.

Skills

RN license / eNLC

Team lead experience

Clinical experience (acute care / reh‑

MS Office proficiency

Independent remote work

Education

Bachelor's Degree

Tools

Microsoft Office Suite

Job description

Humana is seeking a Manager, Utilization Management Nursing to lead coordination and interpretation of medical services and benefit determinations in a remote, home‑based role. You will apply advanced nursing knowledge, guide teams, and collaborate across departments to ensure compliant and efficient patient care.

Candidates must be an active RN (Virginia or eNLC) with 2+ years of leadership and clinical experience; proficiency in MS Office; ability to work independently in a remote setting;