Posted Jul 13, 2026 · Last seen active Jul 15, 2026
About this role
Utilization Management Behavioral Health Registered Nurse (RN) Intern at Humana. Intern will conduct clinical reviews of prior authorization requests to determine medical necessity, apply evidence-based clinical guidelines, communicate with healthcare providers, document review findings, implement quality assurance measures, and educate providers on prior authorization policies. Remote position for transitioning military service members or military spouses. Requires active RN license in Kentucky or enhanced Compact (eNLC) license without restrictions, minimum 2 years clinical behavioral health experience, and proficiency in healthcare software and EMR systems.
Skills for this role
clinical reviews of prior authorization requestsdetermine medical necessityapply evidence-based clinical guidelinescommunicate with healthcare providersdocument review findingsimplement quality assurance measureseducate providers on prior authorization policiesproficiency in healthcare software and EMR systems
Requirements
WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Humana is a health insurance and managed care organization that employs nurses in care management roles rather than traditional clinical settings. Based on the provided job descriptions, Humana hires Field Care Manager Nurses (Physical Health) who assess and coordinate care…
What reviewers appreciate
+Holistic, member-centered approach to care coordination
+Autonomous field-based role with telephonic and face-to-face interactions
+Collaborative work with providers and community resources
What reviewers flag
−Field-based role likely requires significant travel across assigned regions
−Complex care coordination across multiple settings and providers may be administratively demanding
−Managing Medicaid populations may involve high-acuity members with complex social and clinical needs
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