Utilization Management Appeals Nurse
Humana
About this role
The Utilization Management Nurse 2 supports coordination, documentation, and communication of medical services and benefit administration determinations for Medicare Part C grievance and appeals cases. The role prepares case summaries for review by Humana Medicare Medical Directors, reviews medical documentation and prior determinations, and researches claims and benefits. The position collaborates with internal teams, vendors, and medical directors to improve member outcomes and operational processes.
Skills
Qualifications
About Humana
humana.comExplore Medicare plans and health insurance coverage to fit your lifestyle. Turning 65 or recently qualified? Sign up for Medicare coverage! Start with healthy, start with Humana.
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About Humana
Headquarters
San Francisco, CA
Company Size
201-500 employees
Founded
2018
Industry
Technology
Glassdoor Rating
4.2 / 5
Leadership Team
Sarah Johnson
Chief Executive Officer
Michael Chen
Chief Technology Officer
Emily Williams
VP of Engineering
David Rodriguez
VP of Product
Jessica Thompson
Chief Financial Officer
Andrew Park
VP of Sales
Unlock Company Insights
View leadership team, funding history,
and employee contacts for Humana.
Salary
$71k – $98k
per year
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