Utilization Management Nurse

🔥 11 minutes ago

🐊 Florida, Kentucky, +4 more states – Remote

🐊 Florida – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🌪️ Oklahoma – Remote 🌴 South Carolina – Remote ⚔️ Virginia – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Utilize clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations • Interpret clinical criteria, policies and procedures to provide appropriate treatment, care or services for members • Coordinate and communicate with providers, members and other parties to facilitate optimal care and treatment • Apply clinical knowledge, communication skills and independent critical thinking • Make independent decisions regarding work methods and courses of action • Follow established guidelines and procedures • Work with minimal direction and seek guidance when needed

🎯 Requirements

• Licensed Registered Nurse (RN) (Compact License) with no disciplinary action • Bachelor's degree • 3–5 years of Medical Surgery, Heart, Lung or Critical Care Nursing experience • Prior clinical experience, preferably in an acute care, skilled or rehabilitation clinical setting • Comprehensive knowledge of Microsoft Word, Outlook and Excel • Ability to work independently under general instructions and with a team • Ability to work the eastern or central time zone • Home internet with at least 25 Mbps download and 10 Mbps upload speed • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Other whole-person wellness and healthcare opportunities • Remote work arrangement • Occasional travel to Humana offices for training or meetings