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Utilization Management Registered Nurse at Humana - ApplyBlast

Utilization Management Registered Nurse

Humana

11 days ago

3.6 on Glassdoor

Remote

Full Time

Medior

0 applicants

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About this role

The Utilization Management Registered Nurse uses clinical nursing skills to coordinate, document, and communicate medical services and benefit administration determinations for post-acute care services. Reporting to the Manager of Utilization Management, the role involves making determinations based on established medical criteria and communicating with providers and members to facilitate coordinated care. This remote position requires a Compact RN license and clinical experience in settings such as hospitals, skilled nursing facilities, or home health.

Responsibilities

Interpret and support coordination of medical services and benefit administration determinations
Make determinations based on established medical criteria and physician information
Communicate with providers and members to facilitate care and treatment

Skills

Qualifications

Compact Registered Nurse (RN) license

About Humana

humana.com

Headquarters

Louisville, Kentucky, United States

Company Size

10001+ employees

Founded

1961

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