Remote UM RN - Kentucky Medicaid
Humana
Louisville, KY
- Remote job
Humana is seeking an Utilization Management Nurse 2 in Kentucky to review medical necessity, determine level of care, and support discharge planning for Medicaid members. The role requires clinical judgment, cross-functional collaboration, and adherence to state regulations. Remote work at home with weekend scheduling and some travel to the Louisville area for training or meetings. Eligible for incentive bonuses and requires 40-hour weeks. #J-18808-Ljbffr Humana
Vacancy posted 3 days ago
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