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The Utilization Management Registered Nurse position at HumanPanorama requires a licensed RN with clinical experience to manage post-acute care services and ensure appropriate care levels for members. The role emphasizes communication and coordination of medical services, with a focus on improving consumer experiences.
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Job Summary
The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration determinations.
This team manages post-acute care services including Skilled Nursing Facility, Home Health, and Durable Medical Equipment to ensure members receive the appropriate level of care.
Humana offers competitive benefits including medical, dental, vision, 401(k) retirement savings plan, paid time off, and a bonus incentive plan based on performance.
Matching Summary
Match Score: 75
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The Utilization Management Registered Nurse position at HumanPanorama requires a licensed RN with clinical experience to manage post-acute care services and ensure appropriate care levels for members. The role emphasizes communication and coordination of medical services, with a focus on improving consumer experiences.
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Salary
Base: $71,100 - $97,800 per year; Bonus/Equity: Eligible for bonus incentive plan; Benefits: Medical, dental, vision, 401(k), PTO, parental leave
Skills & Requirements
Must-have
Compact RN license in state of residence
Greater than one year clinical experience
Hospital SNF Home Health or acute care setting
Nice-to-have
Previous utilization management experience
Knowledge of Milliman Care Guidelines
Experience with Interqual criteria
Remote metrics-focused role experience
MDS Coordinator or discharge planner background
Key Requirements
Must hold Compact Registered Nurse (RN) license
Greater than one year of clinical experience as an RN
Experience in hospital, SNF, Home Health, or acute care setting