Remote Utilization Management RN — Care Coordination Expert

Humana; Indianapolis (IN); Remote; USD 71,000 - 98,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k)

Job summary

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. The role reports to the Manager of Utilization Management and helps ensure members receive appropriate care in the right setting.

This is a remote position with 40 weekly hours and occasional travel for training. A compact RN license in your state and 1+ year of RN experience in hospital, SNF, Home Health, or acute

Qualifications

• Must hold Compact RN license in your state of residence.
• Greater than one year of RN experience in hospital, SNF, Home Health, or acute care setting.
• Experience in utilization management or utilization review is preferred.

Responsibilities

• Interpret and support coordination, documentation and communication of medical services and benefit determinations.
• Complete request determinations within established processing time frames.
• Communicate with providers, members, and other parties to facilitate care and treatment.
• Understand department and organizational strategy and operating goals.

Skills

RN license

Utilization review

Remote work

Healthcare

Education

BSN preferred

Job description

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. The role reports to the Manager of Utilization Management and helps ensure members receive appropriate care in the right setting.

This is a remote position with 40 weekly hours and occasional travel for training. A compact RN license in your state and 1+ year of RN experience in hospital, SNF, Home Health, or acute