Remote Utilization Management Nurse - Care Coordination

Humana; Indiana; Remote; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) retirement savings plan

Paid time off

Parental and caregiver leave

Job summary

Humana is seeking a licensed Utilization Management Nurse to support coordination, documentation and determinations for medical services and benefit administration. The role requires clinical nursing expertise, independent judgment and effective communication with providers, members and teams.

Remote to work in eastern or central time zones, with occasional travel to Humana offices for training or meetings.

Qualifications

• RN license with no disciplinary action.
• Bachelor's degree required.
• 3–5 years of Medical-Surgical, Heart, Lung or Critical Care nursing experience.
• Prior clinical experience in acute, skilled or rehabilitation settings preferred.
• Proficient in Microsoft Word, Outlook and Excel.

Responsibilities

• Coordinate, document and communicate medical services and benefit determinations.
• Interpret criteria, policies and procedures to determine appropriate care.
• Communicate with providers, members and other parties to facilitate care.
• Work independently under general instructions and provide input when needed.

Skills

Communication skills

Independent critical thinking

Clinical nursing

Education

Registered Nurse license (RN)

Bachelor's degree

Tools

Microsoft Word

Outlook

Excel

Job description

Humana is seeking a licensed Utilization Management Nurse to support coordination, documentation and determinations for medical services and benefit administration. The role requires clinical nursing expertise, independent judgment and effective communication with providers, members and teams.

Remote to work in eastern or central time zones, with occasional travel to Humana offices for training or meetings.