SNF Utilization Management Nurse (RN) - Remote

Overview

The SNF Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations, ensuring optimal care for members.

In Short

• Utilize clinical nursing skills in utilization management.
• Coordinate and document medical services.
• Communicate with providers and members for optimal care.
• Make independent determinations regarding treatment options.
• Follow established guidelines and procedures.
• Work independently and as part of a team.
• Maintain a high-speed internet connection for remote work.
• Occasional travel to Humana's offices may be required.
• Full-time position with a 40-hour work week.
• Eligible for a bonus incentive plan based on performance.

Requirements

• Compact licensure as a Registered Nurse (RN).
• 2-3 years of experience in skilled nursing facilities.
• Comprehensive knowledge of Microsoft Word, Outlook, and Excel.
• Ability to work independently under general instructions.
• Passionate about improving consumer experiences.
• Preferred: BSN or Bachelor's degree in a related field.
• Health Plan experience is a plus.
• Previous Medicare/Medicaid experience is a plus.
• Bilingual candidates are preferred.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability coverage.
• Life insurance and other opportunities.