Remote Utilization Management Nurse

IntelliResume; Kentucky; Remote; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Paid parental and caregiver leave

Short-term and long-term disability

Life insurance

Job summary

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care decisions.

This full-time, remote position offers a competitive salary and comprehensive benefits, with duties including interpreting criteria, coordinating with providers and members, and following established guidelines.

Qualifications

• Bachelor’s degree required.
• 3-5 years of Medical-Surgery, Heart, Lung, or Critical Care Nursing experience.
• Licensed Registered Nurse (RN) with a Compact License

Responsibilities

• Interpret criteria, policies, and procedures using clinical knowledge.
• Coordinate and communicate with providers, members, or other parties to facilitate optimal care.
• Make independent determinations regarding appropriate courses of action.
• Follow established guidelines and procedures.
• Work independently under general instructions and as part of a team.

Skills

Clinical nursing

Independent decision making

Communication skills

Education

Bachelor's degree

Job description

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care decisions.

This full-time, remote position offers a competitive salary and comprehensive benefits, with duties including interpreting criteria, coordinating with providers and members, and following established guidelines.