Remote Front End Review Utilization Management Nurse 2

Task Posting for Utilization Direction Nurse - Weekend Front Terminate Review at Humana Insurance Company

Clarification Utilization Direction Nurse - Weekend Front end Review utilizes clinical nursing skills to support the coordination, documentation and advice of medical services and/or benefit administration determinations. The Utilization Direction Nurse ii piece of work assignments are varied and oftentimes require interpretation and independent conclusion of the appropriate courses of action. 4 X 10's Thursday- Lord's day, 7am-6pm How nosotros Value Yous Benefits starting twenty-four hours i of employment Competitive 401k lucifer Generous Paid Time Off accrual Tuition Reimbursement Parent Get out Go365 perks for well-being Responsibilities The Utilization Management Nurse - Weekend Forepart Finish Review uses clinical knowledge, advice skills, and independent disquisitional thinking skills towards interpreting criteria, policies, and procedures to provide the best and about appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Utilize MCG criteria to perform acute concurrent front end end reviews on Humana members to determine medical necessity. Required Qualifications Licensed Registered Nurse (RN) in Florida with no disciplinary action. 3 or more years experience preferably in an acute intendance, skilled or rehabilitation clinical setting 4 Ten 10's Thursday- Sunday, 7am-6pm Comprehensive noesis of Microsoft Give-and-take, Outlook and Excel Power to work independently nether full general instructions and with a team Must exist passionate about contributing to an organisation focused on continuously improving consumer experiences Preferred Qualifications Bachelor's degree Front Review experience Previous experience in Utilization Management CGX experience MCG feel Health Plan experience Previous Medicare/Medicaid Experience Call eye or triage experience Bilingual Boosted Information Shift Hours- 4 X 10's Thursday- Sunday, 7am-6pm Every bit part of our hiring process, we will be using an exciting interviewing technology provided by Mod Rent, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for controlling. If you are selected to move frontwards from your application prescreen, y'all will receive correspondence inviting y'all to participate in a pre-recorded Vox Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you lot will respond to a set of interview questions via your phone. Yous should anticipate this interview to take approximately ten-15 minutes. If participating in a SMS Text interview, you volition be asked a series of questions to which you will exist using your cell phone or reckoner to answer the questions provided. Look this blazon of interview to concluding anywhere from v-10 minutes. Your recorded interview(due south) via text and/or pre-recorded vocalization will be reviewed and you will subsequently be informed if yous volition exist moving forward to adjacent round of interviews. Piece of work-At-Home Requirements WAH requirements: Must have the power to provide a high speed DSL or cable modem for a habitation office. Associates or contractors who live and piece of work from home in the state of California volition exist provided payment for their net expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Cyberspace service is Not allowed for this part. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA data Internal- If yous have additional questions regarding this part posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please exist sure to provide the requisition number and then we may be able to research your request quicker. Scheduled Weekly Hours xl

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Salary.com Estimation for Utilization Direction Nurse - Weekend Forepart End Review in Florida, NY

$75,298 to $95,382

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