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.

　　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

　　Required Qualifications

　　Current Unrestricted Licensed Registered Nurse (RN) in the state of South Carolina with no active disciplinary action.

　　Live within the state of South Carolina

　　2 years clinical acute care, skilled nursing, rehab or transitional care experience.

　　1 year experience in utilization management

　　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

　　Additional Information / Adherence

　　Workstyle: Remote Work at Home

　　Location: U.S

　　Required Location: South Carolina

　　Schedule

　　Work Schedule: Monday - Friday; 8am - 5pmTravel: 5%

　　Occasional travel up to 1 time per quarterAdditional Requirements

　　Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work.

　　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 of 25x10 (25mbs download x 10mbs upload) is required.

　　Preferred Qualifications

　　Bachelor's degree

　　Health Plan experience

　　Behavioral Health experience

　　Additional Information

　　Interview Process

　　As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

　　If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

　　If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

　　Scheduled Weekly Hours

　　40

　　About us

　　Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. 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. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

　　Equal Opportunity Employer

　　It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. 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.

　　Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.