Remote Utilization Management RN – Improve Patient Outcomes

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

Job summary

Humana is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting, and communicating medical services and benefit determinations. The role involves interpreting data and making independent determinations to support patient outcomes, with standard hours 8:00am–5:00pm ET.

Qualifications include Associate Degree in nursing, RN license in a compact state, 3+ years of clinical experience with geriatric care, strong telephonic/virtual communication, and

Qualifications

• Associate Degree in nursing required.
• RN license in a compact state with no disciplinary action.
• Three+ years of progressive clinical experience including direct geriatric patient care.
• Effective telephonic and virtual communication skills.
• Ability to follow guidelines and work independently or with a team.

Responsibilities

• Coordinate, document, and communicate medical services determinations.
• Support benefit administration determinations.
• Interpret clinical information to improve patient outcomes.

Skills

Organizational skills

Analytical skills

Telephonic/virtual communication

MS Word

Outlook

Excel

Independent work

Education

Associate Degree in nursing

RN license in compact state

Bachelor’s degree (preferred)

Tools

Microsoft Word

Outlook

Excel

Job description

Humana is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting, and communicating medical services and benefit determinations. The role involves interpreting data and making independent determinations to support patient outcomes, with standard hours 8:00am–5:00pm ET.

Qualifications include Associate Degree in nursing, RN license in a compact state, 3+ years of clinical experience with geriatric care, strong telephonic/virtual communication, and