Remote Utilization Management Nurse (RN)

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

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) plan

Paid time off

Disability insurance

Life insurance

Job summary

Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating and documenting medical services and benefit determinations. The role involves independent interpretation of actions, collaborating with internal and external stakeholders, and ensuring adherence to established guidelines.

The ideal candidate has an Associate Degree in nursing, an active compact RN license, and at least three years of geriatric care experience, with strong telephonic and virtual

Qualifications

• Minimum of Associate Degree in nursing.
• Licensed Registered Nurse (RN) in a compact state with no disciplinary action.
• Must have valid compact license or reside in a compact state and be eligible to upgrade to compact licensure.

Responsibilities

• Coordinate and document medical services determinations and/or benefit administration determinations.
• Support communication of determinations to members and providers.

Skills

Communication

Time management

Analytical skills

Telephonic communication

Virtual communication

Nursing knowledge

Teamwork

MS Word

MS Outlook

MS Excel

Education

Associate Degree in nursing

Bachelor’s degree

Tools

Microsoft Word

Outlook

Excel

Job description

Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating and documenting medical services and benefit determinations. The role involves independent interpretation of actions, collaborating with internal and external stakeholders, and ensuring adherence to established guidelines.

The ideal candidate has an Associate Degree in nursing, an active compact RN license, and at least three years of geriatric care experience, with strong telephonic and virtual