Licensed Registered Nurse (RN) in Illinois with no disciplinary action or the ability to obtain IL ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in Illinois with no disciplinary action or the ability to obtain IL ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Compliance Audit Nurse
Oklahoma City, OK · On-site +1
Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Compliance Audit Nurse
Oklahoma City, OK · On-site +1
Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Field Care Manager Registered Nurse key roles and responsibilities may include the following ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Field Care Manager Registered Nurse key roles and responsibilities may include the following ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Field Care Manager Registered Nurse key roles and responsibilities may include the following ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Field Care Manager Registered Nurse key roles and responsibilities may include the following ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Compliance Audit Nurse
Oklahoma City, OK · On-site +1
Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Compliance Audit Nurse
Oklahoma City, OK · On-site +1
Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Field Care Manager Registered Nurse key roles and responsibilities may include the following ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Field Care Manager Registered Nurse key roles and responsibilities may include the following ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Compliance Audit Nurse
Oklahoma City, OK · On-site +1
Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Compliance Audit Nurse
Oklahoma City, OK · On-site +1
Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with compact license in the (appropriate state) with no disciplinary ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) with compact license in the (appropriate state) with no disciplinary ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Licensed Registered Nurse (RN) in the state of Ohio with no disciplinary action. * At least 3 years ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Active Registered Nurse (RN) license * 5 or more years of professional RN experience * 2 or more ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Active Registered Nurse (RN) license * 5 or more years of professional RN experience * 2 or more ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Current, unrestricted Registered Nurse (RN) license in the state of Kentucky * Must be Located ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Current, unrestricted Registered Nurse (RN) license in the state of Kentucky * Must be Located ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Current, unrestricted Registered Nurse (RN) license in the state of Oklahoma * Must be Located ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Current, unrestricted Registered Nurse (RN) license in the state of Oklahoma * Must be Located ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Current, unrestricted Registered Nurse (RN) license in the state of Wisconsin * Must be Located ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Current, unrestricted Registered Nurse (RN) license in the state of Wisconsin * Must be Located ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Remote Humana Rn information
What is the difference between Remote Humana Rn vs Remote UnitedHealthcare Rn?
| Aspect | Remote Humana Rn | Remote UnitedHealthcare Rn |
|---|---|---|
| Credentials | RN license, applicable certifications | RN license, applicable certifications |
| Work Environment | Remote, telehealth settings | Remote, telehealth settings |
| Employer & Industry | Humana, health insurance industry | UnitedHealthcare, health insurance industry |
| Common Search Intent | Comparison of remote nursing roles in Humana and similar companies | Comparison 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.
Does a remote Humana RN offer remote work options?
A remote Humana RN typically offers remote work options, allowing nurses to perform their duties from home. These roles often involve telehealth, case management, or patient support, requiring strong communication skills and relevant certifications. Remote RN positions at Humana are designed to provide flexibility while maintaining healthcare standards.
More about Remote Humana Rn jobs
What cities are hiring for Remote Humana Rn jobs?
Cities with the most Remote Humana Rn job openings:
What are the most commonly searched types of Humana Rn jobs?
The most popular types of Humana Rn jobs are:
What states have the most Remote Humana Rn jobs?
States with the most job openings for Remote Humana Rn jobs include:
What job categories do people searching Remote Humana Rn jobs look for?
The top searched job categories for Remote Humana Rn jobs are:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
This job post has expired 3 days ago. Applications are no longer accepted.
Humana rating
8.0
Based on 267 frontline employees who took The Breakroom Quiz
171st of 315 rated insurance
Job description
Become a part of our caring community
Are you passionate about helping individuals access the services and support they need to live safely and independently in their communities? As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well-being of Illinois Medicaid members by reviewing and authorizing Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS).
You'll combine your clinical expertise, critical thinking, and compassionate approach to evaluate member needs, make evidence-based coverage determinations, and ensure access to appropriate care and services. Working independently while collaborating with providers, members, and interdisciplinary teams, you'll help deliver person-centered, high-quality, and cost-effective healthcare solutions. This position offers the opportunity to make a meaningful impact, navigate complex clinical scenarios, and contribute to an organization dedicated to improving health outcomes and member experiences across Illinois.
Use your skills to make an impact
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.
Are you passionate about helping individuals access the services and support they need to live safely and independently in their communities? As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well-being of Illinois Medicaid members by reviewing and authorizing Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS).
You'll combine your clinical expertise, critical thinking, and compassionate approach to evaluate member needs, make evidence-based coverage determinations, and ensure access to appropriate care and services. Working independently while collaborating with providers, members, and interdisciplinary teams, you'll help deliver person-centered, high-quality, and cost-effective healthcare solutions. This position offers the opportunity to make a meaningful impact, navigate complex clinical scenarios, and contribute to an organization dedicated to improving health outcomes and member experiences across Illinois.
- Use clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures related to Long Term Services and Support authorizations to provide the best and most appropriate treatment, care, or services for members.
- Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment.
- Ensure timely and accurate authorization creation and determinations in accordance with Illinois Department of Healthcare and Family Services (HFS), contractual, and regulatory requirements.
- Review clinical information and make coverage determinations for Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS).
- Make decisions related to denials for HCBS-covered services in accordance with applicable state, contractual, and regulatory guidelines.
- Continue to coordinate and communicate with providers, members, and interdisciplinary teams to facilitate optimal care and service delivery.
Use your skills to make an impact
Required Qualifications
- Licensed Registered Nurse (RN) in Illinois with no disciplinary action or the ability to obtain IL RN licensure prior to start date.
- 1+ years of experience in utilization management/LTSS service authorization.
- 2+ years of clinical experience, preferably in acute care, skilled or rehabilitation clinical setting, or a Medicaid Managed Care Organization.
- Comprehensive knowledge of Microsoft Word, Outlook and Excel
Preferred Qualifications
- Bachelor's degree in nursing, Health Services, Healthcare Administration, Business Administration, or a related field.
- Previous Medicare/Medicaid experience.
- Previous experience in discharge planning and/or home health, HCBS, rehabilitation, or LTSS programs.
Additional Information
- Location: must reside in Illinois, Wisconsin, or Indiana.
- Workstyle: This is a remote position supporting members and providers throughout Illinois with periodic in-office attendance required for meetings, training, collaboration, and other business needs.
- Travel: May be required to attend occasional in-state meetings, training sessions, or provider/member events, up to 25% of the time.
- Schedule: Monday through Friday, 8am to 5pm CST.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.
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.
About Humana
Sourced by ZipRecruiter
Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Louisville, KY, US
Year founded
1961