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Remote Humana Rn Jobs in California (NOW HIRING)

Molina Healthcare

Care Manager (RN)

Long Beach, CA · Remote

This is a remote role with up to 40% possible travel. Job Summary Provides support for care ... Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may ...

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Remote Humana Rn information

What is the difference between Remote Humana Rn vs Remote UnitedHealthcare Rn?

AspectRemote Humana RnRemote UnitedHealthcare Rn
CredentialsRN license, applicable certificationsRN license, applicable certifications
Work EnvironmentRemote, telehealth settingsRemote, telehealth settings
Employer & IndustryHumana, health insurance industryUnitedHealthcare, health insurance industry
Common Search IntentComparison of remote nursing roles in Humana and similar companiesComparison of remote nursing roles in UnitedHealthcare and similar companies

Both Remote Humana Rn and Remote UnitedHealthcare Rn roles involve providing patient care remotely within the health insurance industry. They require similar credentials, such as an active RN license and relevant certifications. The primary difference lies in the employer and specific company policies, but the work environment and job responsibilities are largely comparable, focusing on telehealth services for members of their respective health plans.

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What job categories do people searching Remote Humana Rn jobs in California look for? The top searched job categories for Remote Humana Rn jobs in California are:
What cities in California are hiring for Remote Humana Rn jobs? Cities in California with the most Remote Humana Rn job openings:
Remote Humana Rn jobs near you

Registered Nurse - Utilization Review - RNUR26-06086

NavitasPartners

Rohnert Park, CA • Remote

$40/hr

Full-time

Posted 5 days ago

Job description

Job Title: Registered Nurse – Utilization Review

Location: Santa Rosa, CA

Shift Details: Day Shift | 5x8 Hours | 08:00 AM – 04:30 PM
Contract Duration: 13 Weeks
Orientation: 40 Hours (Non-Billable)

Required Qualifications
  • Active Registered Nurse (RN) License required
  • Minimum 1–2 years acute care experience preferred
  • Experience in Utilization Review, Case Management, or similar clinical coordination role preferred
  • Strong understanding of medical necessity criteria and payer guidelines
  • Knowledge of insurance authorization and review processes
  • Strong documentation, analytical, and communication skills
  • Ability to work independently in a remote setting
  • Experience with EMR systems preferred (Epic preferred)
Job Responsibilities
  • Perform utilization review for inpatient and outpatient services
  • Evaluate medical records for appropriate level of care and medical necessity
  • Process prior authorizations and continued stay reviews
  • Collaborate with physicians, case managers, and insurance payers
  • Document review decisions accurately in EMR systems
  • Identify cases requiring escalation to clinical reviewers or medical directors
  • Support discharge planning and care coordination when needed
  • Ensure compliance with regulatory, payer, and facility guidelines
  • Maintain productivity and quality standards in a remote environment

For more details contact at sthakur@navitashealth.com

About Navitas Healthcare, LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.