Remote Utilization Management RN

Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. The role reports to the Manager of Utilization Management as part of the One Home/Home Solutions Utilization Management team handling post-acute care services such as SNF, Home Health, and DME.

Responsibilities include applying medical criteria to determine care needs, completing determinations within time frames, and