The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
60 Humana Utilization Management Nurse Jobs Hiring Near You
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive ... Humana reserves the right to require associates to upgrade their internet service if necessary.
Support initiatives focused on quality management, utilization management, discharge planning, home ... Support Humana's commitment to continuously improving consumer experiences. * Promote appropriate ...
Support initiatives focused on quality management, utilization management, discharge planning, home ... Support Humana's commitment to continuously improving consumer experiences. * Promote appropriate ...
... of Humana's members and providers. You will report directly to the Associate Director, Data Science. What You'll Do: * Partner with Utilization Management (UM), clinical, and business teams to ...
... of Humana's members and providers. You will report directly to the Associate Director, Data Science. What You'll Do: * Partner with Utilization Management (UM), clinical, and business teams to ...
... Humana policies, and recognized clinical standards. * Analyze complex hospital-based cases and deliver clear, well-reasoned utilization management determinations. * Communicate with external ...
... Humana policies, and recognized clinical standards. * Analyze complex hospital-based cases and deliver clear, well-reasoned utilization management determinations. * Communicate with external ...
Utilization management experience in a medical management review organization, such as Medicare ... Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to ...
Utilization management experience in a medical management review organization, such as Medicare ... Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to ...
Utilization management experience in a medical management review organization, such as Medicare ... Humana reserves the right to require associates to upgrade their internet service if necessary.
Utilization management experience in a medical management review organization, such as Medicare ... Humana reserves the right to require associates to upgrade their internet service if necessary.
Become a part of our caring community The Manager, Care Management leads teams of nurses and ... Monitor performance of staff including service performance and adherence to establish utilization ...
Become a part of our caring community The Manager, Care Management leads teams of nurses and ... Monitor performance of staff including service performance and adherence to establish utilization ...
Become a part of our caring community The Manager, Care Management leads teams of nurses and ... Monitor performance of staff including service performance and adherence to establish utilization ...
Become a part of our caring community The Manager, Care Management leads teams of nurses and ... Monitor performance of staff including service performance and adherence to establish utilization ...
Manager, Care Management
Chicago, IL · On-site
Become a part of our caring community The Manager, Care Management leads teams of nurses and ... Monitor performance of staff including service performance and adherence to establish utilization ...
Manager, Care Management
Chicago, IL · On-site
Become a part of our caring community The Manager, Care Management leads teams of nurses and ... Monitor performance of staff including service performance and adherence to establish utilization ...
Supports Humana values including working collaboratively on a team throughout all activities ... Experience in utilization management review and case management in a health plan setting * No ...
Supports Humana values including working collaboratively on a team throughout all activities ... Experience in utilization management review and case management in a health plan setting * No ...
RN Field Care Manager Nurse
$72K - $88K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$72K - $88K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
Dearborn, MI · On-site
$71K - $87K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
Dearborn, MI · On-site
$71K - $87K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$71K - $87K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$71K - $87K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$76K - $94K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$76K - $94K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$80K - $98K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$80K - $98K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
Roseville, MN · On-site
$80K - $98K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
Roseville, MN · On-site
$80K - $98K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$72K - $88K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
RN Field Care Manager Nurse
$72K - $88K/yr
Certification in Case Management * Motivational Interviewing Certification and/or knowledge ... This role is part of Humana's driver safety program and therefore requires an individual to have a ...
Humana Jobs Information
What is it like to work at Humana?
Humana is a company that prioritizes a culture of compassion, empathy, and community involvement, striving to make a positive impact on people's lives. As a leading health and well-being company, Humana offers a dynamic work environment with diverse teams, opportunities for professional growth, and a mission-driven approach to improving healthcare outcomes. Working at Humana may appeal to candidates who are passionate about making a difference in healthcare and are motivated by the company's commitment to innovation, customer satisfaction, and employee development.
What makes Humana an attractive place to work?
Humana is a leading health and well-being company that has been a pioneer in the healthcare industry for over 60 years, with a strong commitment to improving the health and well-being of its members. The company offers a dynamic and supportive work environment that fosters collaboration, innovation, and professional growth, with opportunities for employees to work on cutting-edge projects and develop their skills in a stable and secure setting. By joining Humana, individuals can contribute to making a meaningful impact in the lives of millions of people, while also advancing their careers and achieving their personal and professional goals.
Do workers at Humana get paid breaks?
Yes. Most people get paid breaks.
76% of people say they get paid breaks.
Based on data from 87 people who took the Breakroom Quiz between July 2025 and July 2026.
76% of people say they get paid breaks.
Based on data from 87 people who took the Breakroom Quiz between July 2025 and July 2026.
Does Humana pay people when they’re sick?
Yes. Most people get paid when they’re sick.
78% of people say they would get paid if they were sick but scheduled to work.
Based on data from 99 people who took the Breakroom Quiz between July 2025 and July 2026.
78% of people say they would get paid if they were sick but scheduled to work.
Based on data from 99 people who took the Breakroom Quiz between July 2025 and July 2026.
At Humana, are sick days and vacation days separate paid time off?
Sick days and vacation days are used from the same paid time off.
92% of people say they have to use vacation days when they’re out sick.
Based on data from 102 people who took the Breakroom Quiz between July 2025 and July 2026.
92% of people say they have to use vacation days when they’re out sick.
Based on data from 102 people who took the Breakroom Quiz between July 2025 and July 2026.
Is the health insurance from Humana affordable enough for their workers?
Most people say the health insurance costs are okay.
89% of people say the health insurance costs are okay
Based on data from 88 people who took the Breakroom Quiz between July 2025 and July 2026.
89% of people say the health insurance costs are okay
Based on data from 88 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people get paid time off at Humana?
Most people get paid time off work.
95% of people say they get paid time off.
Based on data from 108 people who took the Breakroom Quiz between July 2025 and July 2026.
95% of people say they get paid time off.
Based on data from 108 people who took the Breakroom Quiz between July 2025 and July 2026.
How far ahead of time do people find out their work schedule?
Most people find out their schedule less than four weeks ahead of time.
Based on data from 49 people who took the Breakroom Quiz between December 2024 and May 2026.
- 47% of people with changing schedules find out their shifts one week or less ahead of time.
- 8% of people with changing schedules find out their shifts two weeks ahead of time.
- 16% of people with changing schedules find out their shifts three weeks ahead of time.
- 29% of people with changing schedules find out their shifts four weeks or more ahead of time.
Based on data from 49 people who took the Breakroom Quiz between December 2024 and May 2026.
Do workers at Humana worry about hours?
Most people don’t worry about getting enough hours.
91% of people report they don’t worry about getting enough hours.
Based on data from 45 people who took the Breakroom Quiz between June 2025 and June 2026.
91% of people report they don’t worry about getting enough hours.
Based on data from 45 people who took the Breakroom Quiz between June 2025 and June 2026.
Do Humana workers get to choose the shifts they work?
Some people don’t get to choose which shifts they work.
39% report that they don’t have enough control over which shifts they work.
Based on data from 38 people who took the Breakroom Quiz between June 2025 and June 2026.
39% report that they don’t have enough control over which shifts they work.
Based on data from 38 people who took the Breakroom Quiz between June 2025 and June 2026.
How easy is it for Humana workers to change shifts?
Some people find it hard to change shifts.
56% of people report that it’s hard to change shifts if they need to.
Based on data from 32 people who took the Breakroom Quiz between June 2025 and June 2026.
56% of people report that it’s hard to change shifts if they need to.
Based on data from 32 people who took the Breakroom Quiz between June 2025 and June 2026.
How easy is it to get time off at Humana?
Most people find it easy to get time off.
68% of people report it’s easy to get time off.
Based on data from 100 people who took the Breakroom Quiz between July 2025 and July 2026.
68% of people report it’s easy to get time off.
Based on data from 100 people who took the Breakroom Quiz between July 2025 and July 2026.
Do Humana managers change schedules at the last minute?
Most managers don’t change people’s schedules at the last minute.
96% of people say their manager doesn’t change their shift schedule at the last minute.
Based on data from 47 people who took the Breakroom Quiz between June 2025 and June 2026.
96% of people say their manager doesn’t change their shift schedule at the last minute.
Based on data from 47 people who took the Breakroom Quiz between June 2025 and June 2026.
Do jobs at Humana spill into time workers aren’t paid for?
Rarely. The job doesn't usually spill into unpaid time.
21% of people report that their job takes up time that they don’t get paid for.
Based on data from 47 people who took the Breakroom Quiz between June 2025 and June 2026.
21% of people report that their job takes up time that they don’t get paid for.
Based on data from 47 people who took the Breakroom Quiz between June 2025 and June 2026.
How easy is it to take sick days at Humana?
Most people find it easy to take sick days.
80% of people report that it’s easy to take time off if they are sick.
Based on data from 103 people who took the Breakroom Quiz between July 2025 and July 2026.
80% of people report that it’s easy to take time off if they are sick.
Based on data from 103 people who took the Breakroom Quiz between July 2025 and July 2026.
Is a Humana job good for students?
Most students say this is a good place to work if you’re studying.
83% of students report this is a good place to work if you’re studying.
Based on data from 24 people who took the Breakroom Quiz between January 2025 and July 2026.
83% of students report this is a good place to work if you’re studying.
Based on data from 24 people who took the Breakroom Quiz between January 2025 and July 2026.
Is working at Humana good if you’re a parent or caregiver?
Most parents and caregivers say this is a good place to work.
88% of people who care for a child or other relative report this is a good place to work.
Based on data from 57 people who took the Breakroom Quiz between July 2025 and July 2026.
88% of people who care for a child or other relative report this is a good place to work.
Based on data from 57 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people at Humana feel treated with respect by their managers?
Most people feel treated with respect by their managers.
90% of people say they’re treated with respect by their managers.
Based on data from 104 people who took the Breakroom Quiz between July 2025 and July 2026.
90% of people say they’re treated with respect by their managers.
Based on data from 104 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people at Humana get to take their breaks without interruption?
Most people get breaks without interruption.
89% of people report that they get to take their breaks without interruption.
Based on data from 99 people who took the Breakroom Quiz between July 2025 and July 2026.
89% of people report that they get to take their breaks without interruption.
Based on data from 99 people who took the Breakroom Quiz between July 2025 and July 2026.
Is it stressful to work at Humana?
Some people feel stressed out here.
61% of people say they often feel stressed out at work.
Based on data from 98 people who took the Breakroom Quiz between July 2025 and July 2026.
61% of people say they often feel stressed out at work.
Based on data from 98 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people at Humana enjoy their jobs?
Most people enjoy their job.
74% of people report they enjoy their job.
Based on data from 93 people who took the Breakroom Quiz between July 2025 and July 2026.
74% of people report they enjoy their job.
Based on data from 93 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people at Humana recommend working with their team?
Only some people recommend working with their team.
37% of people report that they wouldn’t recommend working with their immediate team to a friend.
Based on data from 108 people who took the Breakroom Quiz between July 2025 and July 2026.
37% of people report that they wouldn’t recommend working with their immediate team to a friend.
Based on data from 108 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people get enough training when they start at Humana?
Most people got enough training when they started.
77% of people report they got enough training when they started working here.
Based on data from 100 people who took the Breakroom Quiz between July 2025 and July 2026.
77% of people report they got enough training when they started working here.
Based on data from 100 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people get support to advance at Humana?
Most people are given support to advance their career here.
In the last year, 67% of people report being given support to advance their career here.
Based on data from 96 people who took the Breakroom Quiz between July 2025 and July 2026.
In the last year, 67% of people report being given support to advance their career here.
Based on data from 96 people who took the Breakroom Quiz between July 2025 and July 2026.
Do people think Humana’s headquarters understands what’s happening where they work?
Most people think headquarters doesn’t understand what’s happening where they work.
70% of people think that this employer’s headquarters or owners don’t have a good understanding of what’s really happening where they work.
Based on data from 91 people who took the Breakroom Quiz between July 2025 and July 2026.
70% of people think that this employer’s headquarters or owners don’t have a good understanding of what’s really happening where they work.
Based on data from 91 people who took the Breakroom Quiz between July 2025 and July 2026.
Do workers feel well informed about how Humana is doing?
Most people feel well informed about how the company is doing.
68% of people feel that they are kept well informed about how the company is doing as a whole.
Based on data from 103 people who took the Breakroom Quiz between July 2025 and July 2026.
68% of people feel that they are kept well informed about how the company is doing as a whole.
Based on data from 103 people who took the Breakroom Quiz between July 2025 and July 2026.
What other companies are hiring for Utilization Management Nurse jobs?
What are the most popular jobs at Humana?
What are the most popular categories at Humana?
Utilization Management RN (Discharge & Auth) Weekends Required
Louisville, KY • On-site, Remote
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 5 days ago
Humana rating
8.0
Based on 263 frontline employees who took The Breakroom Quiz
161st of 299 rated insurance
Job description
Become a part of our caring community
The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. This role has primary responsibility for performing medical necessity reviews, including initial and concurrent authorization decisions, using established clinical criteria and independent clinical judgment. The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care.
Use your skills to make an impact
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
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.
The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. This role has primary responsibility for performing medical necessity reviews, including initial and concurrent authorization decisions, using established clinical criteria and independent clinical judgment. The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care.
The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members.
- Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment.
- Maintain compliance with state regulations and organizational standards for coordinated member discharge, ensuring all plans are documented and communicated effectively.
- Perform initial and concurrent reviews with medical necessity determinations, including level of care and length of stay decisions.
- Engage providers via telephonic, virtual, and onsite collaboration as needed.
- Follows established guidelines/procedures.
The schedule for this position will include weekends, typically Wednesday through Sunday from 8:00 AM to 5:00 PM Eastern Time with flexibility to adjust weekdays off with leader approval.
Use your skills to make an impact
Required Qualifications
Licensed Registered Nurse (RN) in the state of Kentucky, in good standing with no disciplinary action.
2+ years of progressive clinical experience in an acute care, skilled nursing, or rehabilitation setting (preferred).
1+ year of utilization management experience.
Maintain compliance with state regulations and organizational standards, ensuring that we coordinate and document member discharge plans and communicate them.
Experience performing initial and concurrent reviews for medical service requests, with the ability to interpret clinical criteria and apply judgment to support appropriate use and benefit administration.
Experience engaging with providers and care teams through telephonic, virtual, or onsite interactions to facilitate authorizations and support member-centered discharge planning.
Strong proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint.
Preferred Qualifications
Bachelor's degree in nursing.
MCG experience.
Experience in discharge planning, transitions of care, and familiarity with community-based resources and social determinants of health.
Health plan experience.
Medicaid experience.
Bilingual in English and another language. A Language Proficiency Assessment will be conducted to evaluate fluency in reading, writing, and speaking in both languages prior to assignment to a dedicated member service line.
Additional Information
Workstyle: Remote work at home
Location: Must reside in Kentucky or a county that is within contiguous bordering states
Schedule: The schedule for this position will include weekends (Weekend shifts are eligible for a shift differential), from 8:00 AM to 5:00 PM Eastern Time with flexibility to adjust weekdays off with leader approval:
- The position follows a 5-day workweek, which includes both Saturday and Sunday.
- Associates will receive two days off during the week.
- Associates may choose which two weekdays they would like off.
- Once selected, those days off must remain consistent from week to week and cannot vary.
Travel: Travel to the Louisville office about 3-4 times annually.
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