Utilization Management RN - Physical Health, OKLAHOMA REMOTE - Work at Home - Oklahoma
Why Humana?
At Humana, caring is everything. You look after our members and patients. We look after you. If caring means something to you too, we’ve got a spot for you. We design competitive and flexible benefits packages to provide our employees a sense of financial security now and in the future.
Fostering a culture of inclusion is part of the fabric of who we are. We must have a workplace that reflects the people we serve and thrives in part because every person can bring their whole self to work to do their best work. Our vibrant, diverse culture and environment of inclusion is one of our greatest strengths.
About Humana Healthy Horizons
Humana Healthy Horizons is more than a health plan. We’re human care. Humana Healthy Horizons focuses on helping people achieve their best health. Our dedicated strategies across various markets and states are enabled by partnerships with state and local governments, community-based organizations, and national partners committed to removing barriers to helping people achieve their best health.
The Utilization Management (UM) Nurse 2 uses clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations. The Utilization Management Nurse 2's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Position Responsibilities:
- Uses clinical knowledge, communication skills, and independent critical thinking skills toward interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care, or services for Enrollees
- Coordinates and communicates with Providers, Enrollees or other parties to facilitate optimal care and treatment
- Understands department, segment, and organizational …
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Regions Countries Benefits/Perks401(k) retirement savings plan 401(k) retirement savings plan with employer match Bonus incentive plan Career development opportunities Competitive benefits Dental Employee charity matching Employee charity matching program Health benefits Health benefits effective day 1 Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Recognition pay Scholarships Scholarships for eligible dependents Time off Tuition Assistance Vision Vision Benefits Volunteer time Volunteer time off
SkillsClinical Experience Clinical nursing Communication Critical thinking Documentation Healthcare HIPAA Leadership Medicaid Medicare Network Nursing Organizational Rehabilitation Security Strategy Utilization management Wellness
Tasks- Documentation
- Training
3+ years
EducationCommunication DO Registered Nurse
Certifications RestrictionsWork from a dedicated space Work from a dedicated space lacking ongoing interruptions
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9