Utilization Management RN – Physical Health

About This Role

The Utilization Management RN - Physical Health at Humana utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations. This role is ideal for nurses with a strong background in clinical settings who are looking to make an impact in patient care.

Highlights

• Pay : $71,100 - $97,800/year
• Location : Remote, OK
• Residency : Must reside in Oklahoma
• Schedule : Full-time, 40 hours/week
• Sign-On Bonus : Eligible for a bonus incentive plan

What You’ll Do

• Use clinical knowledge to interpret criteria and procedures for optimal treatment and care.
• Coordinate and communicate with providers, enrollees, or other parties to facilitate care.
• Understand department, segment, and organizational strategies and objectives.
• Use judgment regarding work methods in ambiguous situations, receiving guidance as needed.
• Follow established guidelines and procedures.
• Travel periodically to Humana's Oklahoma City office for meetings and training.

Requirements

Education:

• Active Licensed Registered Nurse (RN), unrestricted

Experience:

• 3+ years of prior clinical experience, preferably in an acute care, skilled, or rehabilitation setting

Licenses & Certifications:

• Current RN License in Oklahoma

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off, including company and personal holidays
• Paid parental and caregiver leave
• Short-term and long-term disability
• Life insurance and other opportunities

About Humana

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through their insurance services and CenterWell healthcare services, they make it easier for millions of people to achieve their best health by delivering the care and service needed when required.