Remote Utilization Management RN – Geriatrics

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

Job summary

Humana is seeking an Utilization Management Nurse 2 to apply clinical nursing skills to coordinate, document, and communicate medical services determinations. The role requires independent judgment and collaboration with internal and external teams, with adherence to established guidelines.

Remote position with occasional travel to Humana offices. Ideal candidates hold RN licensure in a compact state, 3+ years of geriatric clinical experience, and strong skills in Microsoft Word, Outlook, and

Qualifications

• Minimum of Associate Degree in nursing.
• Licensed Registered Nurse (RN) in a compact state with no disciplinary action.
• Must have valid compact license or reside in a compact state and be eligible to upgrade to compact licensure.
• Three (3) or more years of progressive and varying clinical experience that includes direct patient care to geriatric population.
• Effective telephonic and virtual communication skills.
• Comprehensive knowledge of Microsoft Word, Outlook and Excel.
• Ability to work independently under general instructions and within a team.

Responsibilities

• Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations.
• Interpret clinical information to make recommendations to improve patient outcomes.
• Collaborate with multiple internal and external parties to drive appropriate care decisions.
• Follow established guidelines, processes and procedures.

Skills

Telephonic and virtual communication

Independent and collaborative work

Clinical information interpretation

System navigation across multiple L2S

Time management and organization

Education

Registered Nurse (RN) with license in a compact state

Associate Degree in Nursing

Bachelor’s degree (preferred)

Tools

Microsoft Word

Outlook

Excel

Job description

Humana is seeking an Utilization Management Nurse 2 to apply clinical nursing skills to coordinate, document, and communicate medical services determinations. The role requires independent judgment and collaboration with internal and external teams, with adherence to established guidelines.

Remote position with occasional travel to Humana offices. Ideal candidates hold RN licensure in a compact state, 3+ years of geriatric clinical experience, and strong skills in Microsoft Word, Outlook, and