[Remote] Utilization Management Nurse at Humana

Candidates must be a Licensed Registered Nurse (RN) in the appropriate state with no disciplinary action (Compact Licensure strongly preferred), have 3+ years of prior clinical experience as a nurse in an acute care setting, comprehensive knowledge of Microsoft Word, Outlook and Excel, excellent communication skills both verbal and written, and the ability to work independently under general instructions and with a team.

This is a Work-At-Home or Hybrid Home/Office role with specific internet requirements: minimum download speed of 25 Mbps and upload speed of 10 Mbps recommended (wireless, wired cable or DSL suggested), and associates in California, Illinois, Montana, or South Dakota receive a bi-weekly internet expense payment. Hours are Monday-Friday 8am-5pm in various time zones, and Humana provides telephone equipment; work from a dedicated space to protect PHI/HIPAA.

The hours are Monday-Friday 8am-5pm across various time zones.

Preferred qualifications include a BSN or Bachelor's degree in a related field, health plan experience, experience in utilization management reviewing criteria for care appropriateness, previous Medicare experience, and Milliman MCG experience.

Benefits starting on day one are offered, though specific details are not listed in the job description.