Remote Utilization Management Nurse | Acute Care RN

Humana; Kentucky; Remoto; USD 59.000 - 98.000; Tempo pieno

Descrizione del lavoro

Humana is seeking an Utilization Management Nurse to support the coordination, documentation and communication of medical services and benefit determinations. This role requires interpreting criteria and policies to determine the best care and to work with providers and members.

Remote to work in eastern or central time zones; travel to Humana offices may be required. You must hold an RN license and a Bachelor's degree with 3–5 years of Medical-Surgical, Critical Care, or related nursing

Competenze

• Licensed RN with no disciplinary action
• Bachelor's degree required
• 3–5 years in Medical-Surgical, Heart, Lung or Critical Care nursing
• Prior clinical experience preferred in acute care, skilled or rehab settings
• Proficient with Word, Outlook and Excel
• Ability to work independently under general instructions and with a team

Mansioni

• Coordinate and communicate with providers, members or other parties to facilitate optimal care.
• Interpret criteria, policies and procedures to provide appropriate treatment or services.
• Make decisions regarding own work methods, occasionally in ambiguous situations.
• Follow established guidelines and procedures.

Conoscenze

Independent thinking

Communication skills

Critical thinking

Work independently

Formazione

Bachelor's degree

RN license

Strumenti

Microsoft Word

Outlook

Excel

Descrizione del lavoro

Humana is seeking an Utilization Management Nurse to support the coordination, documentation and communication of medical services and benefit determinations. This role requires interpreting criteria and policies to determine the best care and to work with providers and members.

Remote to work in eastern or central time zones; travel to Humana offices may be required. You must hold an RN license and a Bachelor's degree with 3–5 years of Medical-Surgical, Critical Care, or related nursing