Humana
Utilization Management Nurse - Home Solutions - Compact RN Required
Humana, United, Louisiana, United States
Utilization Management Nurse – Home Solutions – Compact RN Required
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Utilization Management Nurse - Home Solutions - Compact RN Required
role at
Humana
Base pay range $71,100.00 – $97,800.00 per year
Role The Utilization Management Nurse 2 utilizes clinical nursing skills to support coordination, documentation, and communication of medical services and benefit administration determinations. Work assignments vary and often require independent determination of appropriate courses of action. In this role you will coordinate and communicate with providers, members, and other parties to facilitate optimal care and treatment.
Responsibilities
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Excellent organizational and time‑management skills.
Solid analytical skills to understand and interpret clinical information to make recommendations to improve patient outcomes.
Technical savvy and ability to navigate multiple systems and screens while working cases.
Collaboration skills to effectively interact with multiple parties both internal and external.
An understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Ability to make decisions regarding your own work methods, occasionally in ambiguous situations, and with minimal direction; receiving guidance when needed.
Ability to follow established guidelines, processes, and procedures.
Shift Monday – Friday, 8:00 am – 5:00 pm Eastern Standard Time
Required Qualifications
Minimum of an Associate Degree in nursing.
Licensed Registered Nurse (RN) in a compact state with no disciplinary action.
Must have a valid compact license or reside in a compact state and be eligible to upgrade to compact licensure.
Three (3) or more years of progressive and varying clinical experience that includes direct patient care to the geriatric population.
Effective telephonic and virtual communication skills.
Comprehensive knowledge of Microsoft Word, Outlook, and Excel.
Ability to work independently under general instructions and within a team.
Preferred Qualifications
Bachelor’s degree.
Two (2) handmade years of home health experience and/or utilization management experience.
Experience in a managed care setting.
Health plan experience.
CGX experience.
Work‑At‑Home Requirements
Must have a high‑speed DSL or cable modem for a home office (satellite and wireless internet service is NOT allowed for this role).
A minimum standard speed for optimal performance is 25 mbs download × 10 mbs upload.
Check your internet speed at www.speedtest.net.
A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information.
Travel While this is a remote position, occasionalCustorr travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours 40 hours per week
Pay Range $71,100 – $97,800 per year
Description of Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole‑person well‑being. Associate benefits include medical, dental, and vision coverage, a 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance, and many other opportunities.
About Us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for millions of people to achieve their best health, delivering the care and service they need, when they need it.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. Humana also takes affirmative action in compliance with Section 503 of the Rehabilitation Act and VEVRAA to employ and advance individuals with disability or protected veteran status, basing all employment decisions only on valid job sfe requirements. This policy applies to all employment actions including recruitment, hiring, promotion, transfer, layoff, and training at all levels.
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Utilization Management Nurse - Home Solutions - Compact RN Required
role at
Humana
Base pay range $71,100.00 – $97,800.00 per year
Role The Utilization Management Nurse 2 utilizes clinical nursing skills to support coordination, documentation, and communication of medical services and benefit administration determinations. Work assignments vary and often require independent determination of appropriate courses of action. In this role you will coordinate and communicate with providers, members, and other parties to facilitate optimal care and treatment.
Responsibilities
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Excellent organizational and time‑management skills.
Solid analytical skills to understand and interpret clinical information to make recommendations to improve patient outcomes.
Technical savvy and ability to navigate multiple systems and screens while working cases.
Collaboration skills to effectively interact with multiple parties both internal and external.
An understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Ability to make decisions regarding your own work methods, occasionally in ambiguous situations, and with minimal direction; receiving guidance when needed.
Ability to follow established guidelines, processes, and procedures.
Shift Monday – Friday, 8:00 am – 5:00 pm Eastern Standard Time
Required Qualifications
Minimum of an Associate Degree in nursing.
Licensed Registered Nurse (RN) in a compact state with no disciplinary action.
Must have a valid compact license or reside in a compact state and be eligible to upgrade to compact licensure.
Three (3) or more years of progressive and varying clinical experience that includes direct patient care to the geriatric population.
Effective telephonic and virtual communication skills.
Comprehensive knowledge of Microsoft Word, Outlook, and Excel.
Ability to work independently under general instructions and within a team.
Preferred Qualifications
Bachelor’s degree.
Two (2) handmade years of home health experience and/or utilization management experience.
Experience in a managed care setting.
Health plan experience.
CGX experience.
Work‑At‑Home Requirements
Must have a high‑speed DSL or cable modem for a home office (satellite and wireless internet service is NOT allowed for this role).
A minimum standard speed for optimal performance is 25 mbs download × 10 mbs upload.
Check your internet speed at www.speedtest.net.
A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information.
Travel While this is a remote position, occasionalCustorr travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours 40 hours per week
Pay Range $71,100 – $97,800 per year
Description of Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole‑person well‑being. Associate benefits include medical, dental, and vision coverage, a 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance, and many other opportunities.
About Us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for millions of people to achieve their best health, delivering the care and service they need, when they need it.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. Humana also takes affirmative action in compliance with Section 503 of the Rehabilitation Act and VEVRAA to employ and advance individuals with disability or protected veteran status, basing all employment decisions only on valid job sfe requirements. This policy applies to all employment actions including recruitment, hiring, promotion, transfer, layoff, and training at all levels.
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