Remote Utilization Management RN for Post-Acute Care

Humana; New Jersey; Remote; USD 71,000 - 98,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana’s Utilization Management Registered Nurse uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care (SNF, Home Health, DME). You will report to the Manager of Utilization Management and collaborate with the One Home/Home Solutions team to ensure appropriate care in the right setting.

This remote role requires an RN license in your state, 1+ year clinical RN experience, and a BSN or

Qualifications

• Must hold Compact Registered Nurse (RN) license in your state of residence.
• Greater than one year of clinical experience as a RN in a 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 coordination of medical services and benefit determinations.
• Complete request determinations within established processing time frames.
• Communicate with providers, members, and other parties to facilitate care.
• Work remotely with alignment to organizational goals.

Skills

RN license

Clinical RN experience

Utilization management

Education

BSN or related degree

Job description

Humana’s Utilization Management Registered Nurse uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care (SNF, Home Health, DME). You will report to the Manager of Utilization Management and collaborate with the One Home/Home Solutions team to ensure appropriate care in the right setting.

This remote role requires an RN license in your state, 1+ year clinical RN experience, and a BSN or