Humana utilization review nurse

For people who specialize in care. Both organizations put the needs of the senior at the forefront of everything we do. Nurses and Social Workers make a difference in assisting members in achieving lifelong well-being.

Apply now. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Creating Healthy Communities is good for the Soul. Join Us! 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. 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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

Humana utilization review nurse

The Utilization Management Nurse 2 helps to ensure fully coordinated care at home for our members. Success in this role requires the following:. Must be passionate about contributing to an organization focused on continuously improving consumer experiences. Solid analytical skills to understand and interpret data to make recommendations to improve patient care. Technical savvy and ability to navigate multiple systems and screens while working cases. An understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Ability to make decisions regarding your own work methods, occasionally in ambiguous situations, and with minimal direction receiving guidance where needed. Must have valid compact license or reside in a compact state and be eligible to upgrade to compact licensure. As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire SMS Text Messaging to enhance our hiring and decision-making ability. Modern Hire Text Messaging allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana myworkday. Utilization Management Nurse: Home Solutions. This job is now closed Apply to similar jobs. Job Description.

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Specialties Case Management. Published Jan 7, Can anyone offer insight about this position? Do you work from home, training, average salary, corporate culture? RN In FL.

It's important to prepare for an interview in order to improve your chances of getting the job. Researching questions beforehand can help you give better answers during the interview. Most interviews will include questions about your personality, qualifications, experience and how well you would fit the job. In this article, we review examples of various utilization review nurse interview questions and sample answers to some of the most common questions. The interviewer is trying to understand what drives the Utilization Review Nurse in their work. This question allows the interviewer to gauge whether the Utilization Review Nurse is passionate about their work and whether they are likely to be committed to the job. It also allows the interviewer to understand what motivates the Utilization Review Nurse and what they hope to achieve in their career. I want to help make sure that resources are used efficiently and effectively, and that patients have access to the care they need. There are a few reasons an interviewer might ask this question.

Humana utilization review nurse

To try to control costs and reduce overuse or misuse of medical services like inpatient hospital stay, tests, surgeries, etc. To comply with this law, hospitals started employing nurses to review for the appropriateness of inpatient admissions and to determine if the number of days a patient remains in the hospital is appropriate and necessary; hence, utilization review was created. The goal of UR is to avoid burdening the healthcare system with unnecessary hospitalizations and procedures, all while ensuring that patients receive appropriate and evidence-based care. Private health insurance companies loved the concept of UR so much that they started implementing it on their end by hiring nurses to review prior authorization requests and claims, received from healthcare providers, for appropriateness. Some people use the acronyms UR and UM interchangeably, but there is a difference. UM is a program that a healthcare system has in place to ensure that patient care — from pre-admission to discharge — is medically necessary and cost-efficient.

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I feel incredibly supported and accepted. In this role you will coordinate and communicate with providers, members, or other parties to facilitate optimal member care and treatment. Had a case load of cases to document on Q3days, which was required, and I had to go onsite 3 days a week to 1 acute facility, telephonic review for 2 facililities and 1 SNF. Get to Know Corporate. View all events. Enrollment in any Humana plan depends on contract renewal. The best part of this company is the commitment to associates, which naturally leads to commitment to members. Other job opportunities utilization management i coordinator remote. Your growth drives us forward When you get here, the journey is just beginning. RN In FL. I prefer to go into an office, so I can leave work at work. Examples of those programs include:. I like the stability that working here provides and that Humana values their employees. Specialties Case Management.

So you want to become a utilization review UR nurse? It's a great career choice!

Clinical Opportunities. Flexible workstyles. Humana has really helped my sense of belonging because I feel part of the team. Hybrid, Online, or On-Campus. Share this job:. This is an exciting company headquartered in a city with an excellent quality of life! For people who specialize in care. About Humana IT. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact yourcareer humana. Thank you for the feed back. Each resident will work with a designated preceptor. Post-Master's Certificates. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. I was a supervisor.