Manager, Utilization Management Nursing
Remote
RN · Acute Care
Posted Aug 4 · Not open to new grads
- Shift
- Rotating
- Unit
- Utilization Management
What the listing says
Role
- Schedule
- Rotating
- Weekends
- Weekends required
- Term
- Permanent
- Setting
- Case Management
- Accepts
- RN
- Experience
- 2+ years
Ratio not posted. Ask in the interview.
Pay
About this role
The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. Works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. 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.
Sourced from a public job board.
“Active Licensed Registered Nurse (RN) in Virginia or enhanced compact license, (eNLC) with no disciplinary action Minimum 2 years of team lead and/or project lead experience Minimum 2 years progressive clinical experien…” · from this posting
Requirements
- RN
- Compact RN
- Active Licensed Registered Nurse (RN) in Virginia or enhanced compact license (eNLC) with no disciplinary action
- Minimum 2 years of team lead and/or project lead experience
- Minimum 2 years progressive clinical experience preferably in an acute care, skilled or rehabilitation setting
- Intermediate to Advanced knowledge using Microsoft Office Word, Excel, PowerPoint, navigating multiple systems and platforms
- Ability to troubleshoot and resolve basic technical difficulties in a remote environment
- Ability to work independently under general instructions and with a team
- Bachelor's Degree (preferred)
- Prior supervisory experience including interviewing, hiring, training, performance evaluation, coaching (preferred)
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- 401(k) retirement savings plan
- Paid time off
- Company and personal holidays
- Paid parental leave
- Paid caregiver leave
Place
- City
- Remote
How this role fits you
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About the employer
Humana is a health insurance and managed care organization that employs nurses in care management roles rather than traditional clinical settings. These nurses partner with members and their families to identify needs, address barriers to care, and connect them with…
Worth asking
We can’t answer these from the listing we have. Good ones to ask a recruiter or in the interview.
- Can you walk me through the pay period for the posted $94,900-$130,500 range and differentials?
- What should I expect for weekly hours, holiday, call, and rotation?
- What orientation, preceptor time, and ongoing unit support are included?
- How are patient load, floating, and staffing support handled day to day?
