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.

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.

Humana utilization review nurse

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. This job is eligible for a bonus incentive plan. Humana, Inc. 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, 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. Humana Inc. 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.

Hiring clinical August 25, am - pm.

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.

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. Think of UM as a big umbrella.

Humana utilization review nurse

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.

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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. Utilization Management Nurse: Home Solutions. Humana, Inc. Our clinical capabilities enable Humana to support people in a variety of healthcare settings. Latest Nursing Jobs. Generous K match, financial planning services and a bonus structure that includes an Associate Incentive Plan. Not sure is you will be working from home or not, or which office. After hiring managers and interview teams carefully consider the skills and experiences of applicants, they contact the top candidates via email or phone to schedule an interview. Primary Care. And you are needing help. Must be passionate about contributing to an organization focused on continuously improving consumer experiences. The Utilization Management Nurse 2 helps to ensure fully coordinated care at home for our members. Clinical Opportunities. About Humana IT. It was sink or swim.

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

Sign up. RN In FL. I feel incredibly supported and accepted. The position sounds intense. Majenta Inbound Contact Representative. View all events. Request an Accommodation 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. Building a culture of belonging We strive to create a culture where everyone feels welcome, supported, and empowered to being their authentic selves to work. Benefits starting day one. Specialties Case Management. Search Jobs.