Remote Utilization Management RN: Care Coordinator

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

Benefits offered by this job

Bonus program

Competitive benefits

Job summary

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations. You will work with the One Home/Home Solutions Utilization Management team to manage post-acute care services such as SNF, Home Health and DME.

You will communicate with providers, members, and other parties to facilitate care, deliver coordinated services, and align with organizational goals.

Qualifications

• Must hold a Compact RN license in your state of residence.
• Over one year of clinical RN experience in hospital, SNF, home health, or acute care.
• Ability to contribute to a health plan with a consumer-focused orientation.

Responsibilities

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

Skills

RN license

Clinical experience

Patient communication

Education

BSN

Job description

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations. You will work with the One Home/Home Solutions Utilization Management team to manage post-acute care services such as SNF, Home Health and DME.

You will communicate with providers, members, and other parties to facilitate care, deliver coordinated services, and align with organizational goals.