SNF Utilization Management RN - Compact Rqd
CA
Geriatric
Posted Jun 18
- Hours a week
- 40
- Unit
- Geriatric
What the listing says
Role
- Schedule
- 40 hours
- Term
- Permanent
- Setting
- Telehealth
- Accepts
- RN
- Experience
- 1+ years
Ratio not posted. Ask in the interview.
Pay
- Against the board
- $9/hr below the median
The median for Geriatric in California is $50/hr, across 42 postings.
About this role
Become a part of our caring community and help us put health first
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.
Read the full posting
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.
Use your skills to make an impact
Use your skills to make an impact
Required Qualifications
Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action. MUST have Compact License Greater than one year of clinical experience in a RN role in acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. Comprehensive knowledge of Microsoft Word, Outlook and Excel Ability to work independently under general instructions and with a team Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Education
BSN or Bachelor's degree in a related field Three or more years of clinical experience in an acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. Experience as an MDS Coordinator or discharge planner in an acute care setting Previous experience in utilization management/utilization review for a health plan or acute care setting Compact license PLUS a single state RN Licensure in any of the following non-compact states: California, Hawaii, Nevada, Oregon Health Plan experience Previous Medicare/Medicaid Experience a plus Call center or triage experience Bilingual is a plus
Additional Information
Scheduled Weekly Hours: 40 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Work-At-Home Requirements
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 is 25mbs download x 10mbs upload is required. Check your internet speed at www.speedtest.net A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients’ homes. OneHome’s patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.
About Humana: Humana Inc. (NYSE: HUM) is c
Requirements
- Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action.
- MUST have Compact License
- Greater than one year of clinical experience in a RN role in acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc.
- Comprehensive knowledge of Microsoft Word, Outlook and Excel
- Ability to work independently under general instructions and with a team
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Preferred Qualifications: BSN or Bachelor's degree in a related field
- Preferred Qualifications: Three or more years of clinical experience in an acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc.
- Preferred Qualifications: Experience as an MDS Coordinator or discharge planner in an acute care setting
- Preferred Qualifications: Previous experience in utilization management/utilization review for a health plan or acute care setting
- Preferred Qualifications: Compact license PLUS a single state RN Licensure in any of the following non-compact states: California, Hawaii, Nevada, Oregon
- Preferred Qualifications: Health Plan experience
- Preferred Qualifications: Previous Medicare/Medicaid Experience a plus
- Preferred Qualifications: Call center or triage experience
- Preferred Qualifications: Bilingual is a plus
- Preferred Qualifications: Additional Information
- Preferred Qualifications: Scheduled Weekly Hours: 40
- Preferred Qualifications: Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
- Preferred Qualifications: Work-At-Home Requirements
- Preferred Qualifications: 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).
- Preferred Qualifications: A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required.
- Preferred Qualifications: Check your internet speed at www.speedtest.net
- Preferred Qualifications: A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information.
- Preferred Qualifications: Scheduled Weekly Hours
- Preferred Qualifications: 40
Benefits
- 401(k)
- Paid time off
Place
- City
- CA
- State price level
- 11% above the national average
California index 110.7, where 100 is the national average.
Cost figures from U.S. Bureau of Economic Analysis.
How this role fits you
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About the employer
OneHome is a healthcare organization affiliated with Humana, as evidenced by the company's signature 'help us put health first' messaging in its job postings. OneHome focuses on home-based care and care coordination, employing nurses in clinical roles such as Utilization…
Worth asking
The posting doesn’t answer these. Good ones to ask a recruiter or in the interview.
- Can you walk me through differentials?
- What should I expect for shifts, weekend, 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?