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The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Humana Healthy Horizons is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations.
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Previous experience in utilization management. Become a part of our caring community and help us put health first. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone's voice is heard and respected.
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You will be part of a caring community at Humana. Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Because finding new ways to put health first-for our members and patients and our associates alike-is what we do.
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At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are-whether you are working from home, from the field, from our offices, or from somewhere in between-you will feel welcome here.
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Satellite, cellular and microwave connection can be used only if approved by leadership. 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.
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When you meet us, you can tell we started as a hometown company. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
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Licensed Registered Nurse (RN) (unrestricted) with no disciplinary action. Through our commitments to wellbeing and work-life balance, we support each associate's personal health, purpose, work style, sense of belonging, and security.
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If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. 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.
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These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. 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.
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Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. Prior clinical experience preferably in long term acute care, skilled or rehabilitation clinical setting.
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Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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Work at Home Guidance. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
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You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. 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.
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Where every associate can build a professional path where they learn and thrive. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability.
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This incentive opportunity is based upon company and/or individual performance. Previous Medicare/Medicaid Experience. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
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Title: utilization review coordinator Company: Backcountry Wellness
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