SNF Utilization Management RN

Humana; Town of Texas (WI); Remote; USD 71,000 - 98,000; Full time

Job summary

An established industry player is seeking a dedicated SNF Utilization Management RN to join their caring community. This role emphasizes clinical nursing skills to enhance coordination and communication of medical services. You will utilize your expertise to interpret policies and provide optimal treatment for members. With a focus on improving consumer experiences, you'll thrive in an environment that values independent critical thinking and teamwork. This full-time position offers a competitive salary range and a comprehensive benefits package, ensuring your well-being and professional growth.

Benefits

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Paid time off

Short-term disability

Long-term disability

Life insurance

Qualifications

• 2-3 years of skilled nursing facility experience required.
• Must have a valid RN license with no disciplinary action.
• Comprehensive knowledge of Microsoft Office Suite.

Responsibilities

• Utilize clinical nursing skills for coordination and communication of medical services.
• Make independent decisions regarding work methods.
• Coordinate with providers and members for optimal care.

Skills

Compact licensure

Registered Nurse (RN)

Skilled nursing facility experience

Microsoft Word

Microsoft Outlook

Microsoft Excel

Ability to work independently

Communication skills

Critical thinking skills

Education

BSN or Bachelor's degree in a related field

Job description

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This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$71,100.00/yr - $97,800.00/yr

Become a part of our caring community and help us put health first

The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

Use your skills to make an impact

• Compact licensure
• Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action.
• 2-3 years Skilled nursing facility experience and /or skilled nursing facility utilization management review experience.
• Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
• Comprehensive knowledge of Microsoft Word, Outlook and Excel
• Ability to work independently under general instructions and with a team
• Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 25 x10 (25mbs download x 10mbs upload) is required
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  
  

Preferred Qualifications

• Education: BSN or Bachelor's degree in a related field
• Health Plan experience
• Previous Medicare/Medicaid Experience a plus
• Bilingual is a plus
  
  

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$71,100 - $97,800 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Insurance

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