[Remote] SNF Utilization Management RN - Compact Rqd at Humana

Kentucky, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Skills

Key technologies and capabilities for this role

Licensed Registered Nurse (RN)Compact LicenseClinical experienceAcute careCritical careEmergency roomTrauma unitsMicrosoft WordMicrosoft OutlookMicrosoft ExcelIndependent workTeam collaborationBSNUtilization Management

Questions & Answers

Common questions about this position

Is this a remote position?

Yes, this is a remote position, though occasional travel to Humana's offices for training or meetings may be required.

What license is required for this role?

A Licensed Registered Nurse (RN) in the appropriate state with no disciplinary action is required, and you MUST have a Compact License.

What clinical experience is needed?

Greater than one year of clinical experience in an RN role in an acute care setting is required, with preference for specialty areas such as critical care, emergency room, or trauma units.

What are the work-at-home technical requirements?

You must have a high-speed DSL or cable modem (no satellite or wireless internet) with a minimum speed of 25mbs download x 10mbs upload for optimal performance.

What makes a strong candidate for this role?

Strong candidates have a Compact License, acute care experience preferably in critical care or ER, utilization management background, and are passionate about improving consumer experiences while working independently and in a team.

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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