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61 Humana Utilization Management Nurse Jobs Hiring Near You

INTUS INC

Contract Utilization Management Nurse

$42/hr

Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This ...

Intus, Inc

Contract Utilization Management Nurse

$42/hr

Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Utilization Management Nurse Consultant We're building a world of health around every individual -- shaping a more connected, convenient and compassionate health experience. At CVS Health ® , you'll ...

Solis Health Plans

Utilization Management Nurse

Miami, FL · On-site

$60K - $70K/yr

Under the supervision of the Health Services Director, the Utilization Management Nurse (LPN or RN) uses a multidisciplinary approach to organize, coordinate, monitor, evaluate, create and manage ...

New

HealthCheck360

Utilization Management Nurse

Asbury, IA · On-site

Utilization Management Nurse Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a ...

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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 August 2025 and August 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 98 people who took the Breakroom Quiz between August 2025 and August 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.
91% of people say they have to use vacation days when they’re out sick.
Based on data from 101 people who took the Breakroom Quiz between August 2025 and August 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.

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 107 people who took the Breakroom Quiz between August 2025 and August 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.
  • 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.

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.

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.

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 99 people who took the Breakroom Quiz between August 2025 and August 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.

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.

How easy is it to take sick days at Humana?

Most people find it easy to take sick days.
79% of people report that it’s easy to take time off if they are sick.
Based on data from 102 people who took the Breakroom Quiz between August 2025 and August 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.

Is working at Humana good if you’re a parent or caregiver?

Most parents and caregivers say this is a good place to work.
87% of people who care for a child or other relative report this is a good place to work.
Based on data from 52 people who took the Breakroom Quiz between August 2025 and August 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 103 people who took the Breakroom Quiz between August 2025 and August 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 98 people who took the Breakroom Quiz between August 2025 and August 2026.

Is it stressful to work at Humana?

Some people feel stressed out here.
62% of people say they often feel stressed out at work.
Based on data from 97 people who took the Breakroom Quiz between August 2025 and August 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.

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 107 people who took the Breakroom Quiz between August 2025 and August 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 99 people who took the Breakroom Quiz between August 2025 and August 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.

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.
71% 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 90 people who took the Breakroom Quiz between August 2025 and August 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.
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?
Infographic showing various Utilization Management Nurse job openings at Humana in the United States as of August 2026, with employment types broken down into 98% Full Time, and 2% Part Time. Highlights an 67% Physical, 6% Hybrid, and 27% Remote job distribution.

Utilization Management Nurse

Presidential Staffing Solutions, LLC

Los Angeles, CA • On-site

$60 - $75/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 7 days ago

Job description

Benefits:
  • 401(k)
  • Competitive salary
  • Dental insurance
  • Health insurance
  • Paid time off
  • Signing bonus
  • Training & development
  • Vision insurance
Outpatient Case Management
West Los Angeles VAMC
11301 Wilshire Blvd
Los Angeles, CA. 90073
There are five new RN vacancies at the West Los Angeles VA Medical Center.
Service Line | Unit | Position Title | Tour | Qualified Contractor | Vendor
HOSPITAL OPERATIONS | INPATIENT | RN | 0630-1500 | Vacant | Open
HOSPITAL OPERATIONS | INPATIENT | RN | 0630-1500 | Vacant | Open
HOSPITAL OPERATIONS | INPATIENT | RN | 0630-1500 | Vacant | Open
HOSPITAL OPERATIONS | OUTPATIENT | RN | 0730-1600 | Vacant | Open
HOSPITAL OPERATIONS | OUTPATIENT | RN | 0730-1600 | Vacant | Open

Benefits/Perks
  • Competitive Compensation
  • Great Work Environment
  • Career Advancement Opportunities
Job Summary
We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your role will be to ensure we are running at optimal efficiency, and that all patients under our care are receiving the necessary treatments and procedures. The ideal candidate has deep experience in a similar medical setting, has a bachelor's or higher in Nursing, and has a certification in either Case Management or Utilization Management.

Responsibilities
  • Review patient files and treatment information for efficiency
  • Monitor the activity of staff to ensure effective patient treatment
  • Advocate for quality patient care to prevent complications
  • Review discharge information for outgoing patients
  • Work closely with clinical staff to provide excellent patient care
  • Prepare reports on patient management and cost assessments
Dimensions of Nursing Practice
PRACTICE: Knowledge of professional nursing practice and the ability to apply the nursing process (assessment, diagnosis, outcome identification, planning, implementation, and evaluation) with close supervision.
Expectations:
1. Completes orientation according to expected standards.
2. Works with close supervision, is responsible and accountable for individual nursing practice and seeks direction from others as needed.
3. Manages workload as assigned, organizes, and completes own assignments in an efficient and appropriate manner.
4. Participates in the development, implementation, and evaluation of interdisciplinary care.
5. For Inpatient RNs, performs unit based inpatient case management duties, with the ability to perform RN case management assessments, discharge planning, formulating safe plans of care and anticipating patient care needs.
VETERAN/PATIENT DRIVEN CARE: Knowledge of Veteran/patient driven care, patient experience, satisfaction, and safety.
Expectations:
1. Establishes a therapeutic relationship, allowing the patient to attain, maintain or regain optimal function through assessment and treatment.
2. Engages patients, families, and other caregivers to incorporate knowledge, values, and beliefs into care planning without judgement or discrimination.
3. Knowledgeable of ethical issues related to professional nursing practice and follow established policies of the practice setting, VA, and ANA Code of Ethics for Nurses.
4. Aware of high reliability principles to deliver consistent care and improve patient outcomes.
LEADERSHIP: Communicates, collaborates, and utilizes leadership principles to perform as an effective member of the interprofessional team.
Expectations:
1. Demonstrates positive, effective communication skills and professional behaviors that promote cooperation and teamwork with internal and external customers.
PROFESSIONAL DEVELOPMENT: Incorporates educational resources/opportunities and self-evaluation for professional growth.
Expectations:
1. Participates in unit based educational activities and continuing education requirements.
2. Responsible for maintaining competency to continue personal and professional growth.
EVIDENCE-BASED PRACTICE/RESEARCH: Awareness of evidence-based practice/research to improve quality of care and resource utilization.
Expectations:
1. Applies evidence-based practice/research to patient care.
2. Participates in unit-based activities to improve and deliver cost effective patient care.
3. Demonstrates knowledge of specific unit level performance improvement activities.
4. Incorporates patient preferences into shared care delivery decisions.
Customer Services Requirements: The incumbent meets the needs of the Veteran and as appropriate the Veteran's family, caregiver and/or significant other, the Veteran's representative, visitors to VA facilities, all VA staff and other customers while supporting VA missions. The incumbent consistently communicates and treats the Veteran and as appropriate the Veteran's family, caregiver and/or significant other, the Veteran representatives, visitors to VA facilities, all VA staff, and other customers in a courteous, tactful, and respectful manner. The incumbent provides the Veteran's family, caregiver and/or significant other, the Veteran's representative, visitors to VA facilities, all VA staff, and other customers with consistent information according to establish policies and procedures. The incumbent handles conflict and problems in dealing with any consumer group appropriately and in a constructive manner.
Age, Development, and Cultural Needs of Patients Requirement: The primary age of Veterans treated is in their middle years (ages 40 to 50) or at the geriatric level (ages 60 or older). There are occasionally younger patients between the ages of 25 to 40 years of age that require care. The position requires the incumbent to possess or develop an understanding of the particular needs of these types of patients. Sensitivity to the special needs of all patients in respect to age, developmental requirements, and culturally related factors must be consistently achieved. Computer Security Requirement: The incumbent protects printed and electronic files containing sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws, Federal regulations, VA statutes and policy, and VHA policy. The incumbent protects the data from unauthorized release or from loss, alteration, or unauthorized deletion. Follows applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in the computer access agreement that the incumbent signs. Reports all known information security incidents or violations to the supervisor and/or the Information Security Officer immediately. Reports all known privacy incidents or violations to the Privacy Officer immediately. Compliance is measured by supervisory observation and periodic random monitoring by the Information Security Officer or Office of Information Technology staff. Major violations such as loss of or unauthorized release, alteration, or deletion of sensitive data are unacceptable.
Other Significant Information: This position potentially requires flexibility in schedule and assignments. For RN Inpatient Case Management staff, there may be rotation to 0830-1700 from the initial 0630-1500 (Monday - Friday)

Qualifications:
  • BSN and/or MSN preferred.
  • Minimum of 5 years of successful nursing practice, encompassing education, administration, leadership, and Quality Management Performance Improvement (QM/PI) experience preferred.
  • Basic computer literacy proficiency with the use of Microsoft Office programs or comparable word processing, spreadsheet and graphic software and the ability to learn new programs specific to the VA preferred.
  • Ability to work variable and flexible tours to meet program demands.
  • Demonstrated ability to accurately implement policies, regulations, standards of care and standards of practice preferred.
  • Demonstrated ability to review patient clinical records.
  • Proven ability to facilitate group problem solving preferred.
  • Proven ability to utilize sound judgment in making patient transfer decisions preferred.
  • Ability to lead and effectively direct staff within program unit/team/group preferred.
  • Excellent organizational, communication, writing, and time management skills preferred.
  • Excellent interpersonal skills and the ability to work independently as well as collaboratively with multiple service lines and disciplines preferred.
Employment Type: FULL_TIME

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