Weekend Utilization Management Nurse 2

Profile

Description

The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

SCHEDULE : 4 - 10 hour days: Saturday, Sunday, Monday, Tuesday

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. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

BSN or Bachelor's degree in a related field

At least 3 years of clinical experience

RN license in a compact state

Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action.

Previous experience in utilization management required

3-5 years clinical experience preferably in an acute care, skilled or rehabilitation clinical setting

Comprehensive knowledge of Microsoft Word, Outlook and Excel

Ability to work independently under general instructions and with a team

Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

SCHEDULE : 4 - 10 hour days: Saturday, Sunday, Monday, Tuesday

Preferred Qualifications

Previous experience in case management

Health Plan experience

Bilingual is a plus

Additional Information

Working in the state of Arizona must comply with the Tobacco Free Hiring Policy and upon offer will be subjected to nicotine testing as part of a 10-panel drug test

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will receive a text with interview questions and you will provide responses to each question. Your interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com