Conviva Senior Primary Care
Utilization Management Nurse
Conviva Senior Primary Care - Frankfort, Kentucky, United States
Work at Conviva Senior Primary Care
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Overview
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Utilization Management Nurse
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Utilization Management Nurse
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Conviva Senior Primary Care Get AI-powered advice on this job and more exclusive features. Conviva Senior Primary Care provided pay range
This range is provided by Conviva Senior Primary Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$71,100.00/yr - $97,800.00/yr Become a part of our caring community and help us put health first
Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we’re seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole.
Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others.
Preferred Locations:
Daytona, FL, Louisville, KY, San Antonio, TX
Role Essentials
Use your skills to make an impact
Active RN license Possession of or ability to obtain Compact Nursing License A minimum of three years clinical RN experience; Prior clinical experience, managed care experience, DME, Florida Medicaid OR utilization management experience Demonstrates Emotional Maturity Ability to work independently and within a team setting Valid driver’s license and/or dependable transportation necessary Travel for offsite Orientation 2 to 8 weeks Travel to offsite meetings up to 6 times a year as requested Willing to work in multiple time zones Strong written and verbal communication skills Attention to detail, strong computer skills including Microsoft office products Ability to work in fast paced environment Ability to form positive working relationships with all internal and external customers Available for On Call weekend/holiday rotation if needed
Role Desirables
Education: BSN or bachelor’s degree in a related field Experience with Florida Medicaid Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures Compact License preferred Previous experience in utilization management within Insurance industry Previous Medicare Advantage/Medicare/Medicaid Experience a plus Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. Bilingual
We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description Of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 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.
Application Deadline: 09-30-2025
About Us
About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
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Utilization Management Nurse
role at
Conviva Senior Primary Care 1 day ago Be among the first 25 applicants Join to apply for the
Utilization Management Nurse
role at
Conviva Senior Primary Care Get AI-powered advice on this job and more exclusive features. Conviva Senior Primary Care provided pay range
This range is provided by Conviva Senior Primary Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$71,100.00/yr - $97,800.00/yr Become a part of our caring community and help us put health first
Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we’re seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole.
Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others.
Preferred Locations:
Daytona, FL, Louisville, KY, San Antonio, TX
Role Essentials
Use your skills to make an impact
Active RN license Possession of or ability to obtain Compact Nursing License A minimum of three years clinical RN experience; Prior clinical experience, managed care experience, DME, Florida Medicaid OR utilization management experience Demonstrates Emotional Maturity Ability to work independently and within a team setting Valid driver’s license and/or dependable transportation necessary Travel for offsite Orientation 2 to 8 weeks Travel to offsite meetings up to 6 times a year as requested Willing to work in multiple time zones Strong written and verbal communication skills Attention to detail, strong computer skills including Microsoft office products Ability to work in fast paced environment Ability to form positive working relationships with all internal and external customers Available for On Call weekend/holiday rotation if needed
Role Desirables
Education: BSN or bachelor’s degree in a related field Experience with Florida Medicaid Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures Compact License preferred Previous experience in utilization management within Insurance industry Previous Medicare Advantage/Medicare/Medicaid Experience a plus Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. Bilingual
We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description Of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 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.
Application Deadline: 09-30-2025
About Us
About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
Job function Health Care Provider Industries Hospitals and Health Care Referrals increase your chances of interviewing at Conviva Senior Primary Care by 2x Get notified about new Nurse jobs in
Kentucky, United States . NON-COMPACT STATE - PT Remote CCM/RTM Care Management Nurse (CA)
Nurse Case Manager/Advocate- Louisville, KY (Remote)
Chronic Care Manager (Remote - Compact States)
Cynthiana, KY $58,282.00-$93,870.00 3 months ago Louisville, KY $75,000.00-$89,000.00 2 weeks ago Remote Nurse Practitioner (Telehealth, Full Time)
Elizabethtown, KY $1,984.72-$1,984.72 2 weeks ago Nursing (MSN Program)- Part-time Faculty
Mixed Acuity Tele - Registered Nurse - $2,131 per week
Frankfort, KY $54,095.00-$116,760.00 9 hours ago Kentucky, United States $75,000.00-$95,000.00 1 week ago Registered Nurse - RN / Progressive Care Unit - TELE-P
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr