Utilization Management Registered Nurse - Home Health

Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Nurse 2 helps to ensure fully coordinated care at home for our members. Excellent organizational and time management skills • Shift is Monday - Friday 8:00am - 5:00pm Eastern Standard Time Minimum of Associate Degree in nursing • Licensed Registered Nurse (RN) in a compact state with no disciplinary action. • Three (3) or more years of progressive and varying clinical experience that includes direct patient care to geriatric population • Effective telephonic and virtual communication skills • Comprehensive knowledge of Microsoft Word, Outlook and Excel • Bachelor’s degree • Two (2) or more years of home health experience and/or utilization management experience • Experience in a managed care setting • Health Plan experience • Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). • A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required. • A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information. To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: wireless, wired cable or DSL connection is suggested. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.This position is subject to Florida Level 2 background screening through the Care Provider Background Screening Clearinghouse. 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. 71,100 - $97,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Humana: Humana Inc. (S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. 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.