Remote Utilization Management RN - Care Coordination

Humana Inc; Olympia (WA); 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

Job summary

Humana Inc. is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and determinations for medical services and benefit administration.

You will report to the Manager of Utilization Management and serve as a member of the One Home/Home Solutions Utilization Management team, focusing on post-acute care services including SNF, Home Health and DME. Responsibilities include applying clinical nursing skills to determine medical necessity,

Qualifications

• Must hold Compact RN license in your state of residence.
• Greater than one year of clinical experience as a RN in hospital, SNF, Home Health or acute care setting.
• Must be passionate about contributing to an organization focused on improving consumer experiences.

Responsibilities

• Interpret and support the coordination, documentation and communication of medical services and benefit administration determinations.
• Make determinations based on established medical criteria using information from physicians and other care providers.
• Communicate with providers, members, or other parties to facilitate care and treatment.

Skills

Clinical nursing

Communication

Documentation

Care coordination

Education

BSN or Bachelor’s degree

Compact RN license

Job description

Humana Inc. is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and determinations for medical services and benefit administration.

You will report to the Manager of Utilization Management and serve as a member of the One Home/Home Solutions Utilization Management team, focusing on post-acute care services including SNF, Home Health and DME. Responsibilities include applying clinical nursing skills to determine medical necessity,