Humana, Inc. is seeking a Pre-Authorization Nurse to review prior authorization requests and determine appropriate care and setting. The role involves clinical judgment to complete medical necessity reviews and refer complex cases to stakeholders.
Responsibilities include educating providers on utilization processes, data entry in management systems, and making independent decisions within established guidelines. Remote work is available with potential travel for meetings.
#J-18808-LjbffrRemote RN: Utilization & Pre-Auth Specialist in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.