Remote Utilization Management RN — Care Coordination

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

Job summary

Humana is seeking an Utilization Management Nurse 2 to coordinate, document, and communicate medical services and benefit determinations. The role requires clinical nursing expertise, independent decision-making, and strong telephonic communication in a remote setting.

The candidate will interpret clinical data to support patient outcomes, collaborate with internal teams, and operate across multiple systems while following established guidelines.

Qualifications

• Minimum of Associate Degree in nursing.
• Licensed Registered Nurse (RN) in a compact state with no disciplinary action.
• Three (3) or more years of progressive and varying clinical experience that includes direct patient care to geriatric population.
• Effective telephonic and virtual communication skills.
• Comprehensive knowledge of Microsoft Word, Outlook and Excel.

Responsibilities

• Coordinate, document and communicate medical services and benefit administration determinations.
• Support coordination and communication across internal and external stakeholders.
• Interpret clinical information to make recommendations to improve patient outcomes.
• Navigate multiple systems and screens while handling cases.

Skills

RN licensure

Telephonic/virtual communication

Independent decision-making

Organizational skills

Collaboration

Education

Associate Degree in Nursing

Compact-state RN licensure

Tools

Microsoft Word

Outlook

Excel

Job description

Humana is seeking an Utilization Management Nurse 2 to coordinate, document, and communicate medical services and benefit determinations. The role requires clinical nursing expertise, independent decision-making, and strong telephonic communication in a remote setting.

The candidate will interpret clinical data to support patient outcomes, collaborate with internal teams, and operate across multiple systems while following established guidelines.