Remote Utilization Management RN - Home Health

Humana, Inc.; North Carolina; Hybrid; USD 71,000 - 98,000; Full time

Job summary

Humana, Inc. is seeking a Utilization Management Registered Nurse - Home Health to support coordination, documentation and communication of medical services and benefit determinations. This role helps ensure fully coordinated home health care for Humana members in a remote-capable setup.

The position requires an RN licensed in a compact state, 3+ years of clinical experience with geriatric care, and strong telephonic/virtual communication skills. Proficiency with Word/Outlook/Excel is expected.

Qualifications

• Associate degree in nursing and RN license in a compact state.
• Three or more years of progressive clinical experience including direct geriatric patient care.
• Strong telephonic and virtual communication skills.
• Proficiency with Microsoft Word, Outlook and Excel.

Responsibilities

• Coordinate and document utilization management decisions for home health.
• Collaborate with internal and external teams to ensure coordinated member care.
• Interpret and apply guidelines to determine appropriate course of action.

Skills

RN experience

Analytical skills

Organizational skills

Independent worker

Education

Associate Degree in Nursing

Bachelor’s degree

Tools

Microsoft Word

Outlook

Excel

Job description

Humana, Inc. is seeking a Utilization Management Registered Nurse - Home Health to support coordination, documentation and communication of medical services and benefit determinations. This role helps ensure fully coordinated home health care for Humana members in a remote-capable setup.

The position requires an RN licensed in a compact state, 3+ years of clinical experience with geriatric care, and strong telephonic/virtual communication skills. Proficiency with Word/Outlook/Excel is expected.