Remote Utilization Management RN | Care Optimization

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

Benefits offered by this job

Bonus incentive plan

Job summary

Humana is seeking a Utilization Management Nurse 2 to support coordination, documentation, and communication of medical services and benefit determinations. The role requires interpreting clinical information and making independent decisions to improve patient outcomes.

The position operates Monday–Friday, 8:00am–5:00pm ET, with remote/work-from-home options and occasional travel to Humana offices for training or meetings. A registered nurse with a compact license is required.

Qualifications

• Associate degree in nursing and RN license in a compact state.
• Three+ years of progressive clinical experience including direct patient care for geriatric population.
• Effective telephonic and virtual communication skills.
• Proficiency with Microsoft Word, Outlook and Excel.
• Ability to work independently within a team.

Responsibilities

• Coordinate and document medical services determinations.
• Communicate authorization/benefit decisions to stakeholders.
• Interpret clinical information to improve patient outcomes.

Skills

Organizational skills

Time management

Analytical skills

Communication skills

Teamwork

Decision making

Education

Associate Degree in Nursing

Compact RN license

Bachelor’s degree (preferred)

Tools

Microsoft Word

Microsoft Outlook

Excel

Job description

Humana is seeking a Utilization Management Nurse 2 to support coordination, documentation, and communication of medical services and benefit determinations. The role requires interpreting clinical information and making independent decisions to improve patient outcomes.

The position operates Monday–Friday, 8:00am–5:00pm ET, with remote/work-from-home options and occasional travel to Humana offices for training or meetings. A registered nurse with a compact license is required.