Utilization Management Nurse - Home Solutions - Compact RN Required

📍 Remote
HumanaRemote NursingSep 16, 2025
Type
Full-Time
Level
Mid Level
Education
Associate's Degree

Overview

Utilization Management Nurse role at Humana, requiring a compact RN license and experience in home health or utilization management.

Job Description

## Content Summary

### Job Description:
The Utilization Management Nurse 2 helps to ensure fully coordinated care at home for our members. Success in this role requires the following:

- Shift is Monday - Friday 8:00am - 5:00pm Eastern Standard Time
- Required Qualifications
- Preferred Qualifications
- Work-At-Home Requirements
- Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
- Scheduled Weekly Hours
- Description of Benefits

### Equal Opportunity Employer
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.

### Requirements & Details:
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
- Excellent organizational and time management skills
- Solid analytical skills to understand and interpret clinical information to make recommendations to improve patient outcomes.
- Technical savvy and ability to navigate multiple systems and screens while working cases.
- Collaboration skills to effectively interact with multiple parties both internal and external.
- An understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
- Ability to make decisions regarding your own work methods, occasionally in ambiguous situations, and with minimal direction receiving guidance where needed.
- Ability to follow established guidelines, processes, and procedures.
- Minimum of Associate Degree in nursing
- Licensed Registered Nurse (RN) in a compact state with no disciplinary action.
- Must have valid compact license or reside in a compact state and be eligible to upgrade to compact licensure.
- 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
- Ability to work independently under general instructions and within a team.
- 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
- CGX 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.
- Check your internet speed at www.speedtest.net
- A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information

Required Skills

organizational skillstime managementanalytical skillstechnical savvycollaboration skillstelephonic communicationvirtual communicationMicrosoft WordOutlookExcel

Job Details

Job Type
Full-Time
Experience Level
Mid Level
Education
Associate's Degree
Location
Remote

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Utilization Management Nurse - Home Solutions - Compact RN Required at Humana | JibJob