Description
At Humana, you're part of a caring community where your clinical nursing skills will make a real difference. As a Utilization Management (UM) Nurse 2, you'll use your expertise to support the coordination, documentation, and communication of medical services and benefit administration determinations.
Responsibilities:
- Interpret criteria and procedures to provide the best treatment, care, or services for Enrollees
- Coordinate and communicate with Providers, Enrollees, or other parties to facilitate optimal care and treatment
- Understand department, segment, and organizational strategy and operating objectives
- Use judgment regarding own work methods, occasionally in ambiguous situations
- Follow established guidelines and procedures
- Periodic travel to Humana Oklahoma City office for meetings and training
Requirements:
- Active Licensed Registered Nurse (RN), unrestricted
- 3+ years of prior clinical experience, preferably in an acute care, skilled or rehabilitation clinical setting
- Comprehensive knowledge of Microsoft Excel and Outlook
- Ability to work a weekend rotation
- Must reside in Oklahoma
Preferred Qualifications:
- Previous experience in Utilization Management
- Prior experience with EPIC Programs
- Previous remote work experience
Benefits:
- Competitive benefits package, including medical, dental, and vision benefits
- 401(k) retirement savings plan
- Time off, including paid time off, company and personal holidays, paid parental and caregiver leave
- Short-term and long-term disability, life insurance, and other opportunities
Salary: $71,100 - $97,800 per year Scheduled Weekly Hours: 40