Utilization Management Nurse

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination of medical services and benefit determinations. You will work with a team handling post-acute care services including SNF, home health, and DME, reporting to the Manager of Utilization Management.

You will apply clinical criteria to make determinations, complete requests within timeframes, and communicate with providers and members to facilitate care, while aligning with department and