[Remote] Utilization Management Nurse at Humana

Candidates must be a licensed Registered Nurse (RN) in the appropriate state with no disciplinary action, and compact licensure is strongly preferred. A minimum of 3 years of prior clinical experience as a nurse in an acute care setting is required, along with comprehensive knowledge of Microsoft Word, Outlook, and Excel. Excellent verbal and written communication skills are essential, as is the ability to work independently under general instructions and as part of a team. The role requires a passion for improving consumer experiences and the ability to work weekends (Saturday/Sunday). A BSN or Bachelor's degree in a related field, health plan experience, and previous experience in utilization management or reviewing criteria for appropriateness of care are preferred. Previous Medicare experience and Milliman MCG experience are also a plus.