Utilization Management RN - Physical Health
- Pay
- $71,100 – $97,800 per year
- Location
- Remote (US)
- Listed
- 3 days ago
About the role
Become a part of our caring community
Position Responsibilities
- Use clinical knowledge toward interpreting criteria and procedures to provide the best and most appropriate treatment, care, or services for Enrollees
- Coordinate and Communicate with Providers, Enrollees or other parties to facilitate optimal care and treatment
- Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas
- Use judgment regarding own work methods, occasionally in ambiguous situation, and receiving guidance where needed
- Follow established guidelines and procedures
- Periodic travel to Humana Oklahoma City office for meetings and training
Required Qualifications
- Must Reside in Oklahoma
- An active Licensed Registered Nurse (RN), unrestricted
- 3+ years of prior clinical experience, preferably in an acute care, skilled or rehabilitation clinical setting
- Comprehensive knowledge of Microsoft Excel and Outlook
- Ability to work a weekend rotation
Preferred Qualifications
- Previous experience in Utilization Management
- Prior experience with EPIC Programs
- Previous remote work experience
Work at Home Requirements
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
- In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs.
- Humana reserves the right to require associates to upgrade their internet service if necessary.
- Work from a dedicated space lacking ongoing interruptions 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
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Why Humana?
At Humana, caring is everything. You look after our members and patients. We look after you. If caring means something to you too, we've got a spot for you. We design competitive and flexible benefits packages to provide our employees a sense of financial security now and in the future.
Fostering a culture of inclusion is part of the fabric of who we are. We must have a workplace that reflects the people we serve and thrives in part because every person can bring their whole self to work to make an impact. Our vibrant, diverse culture and environment of inclusion is one of our greatest strengths.
About Humana Healthy Horizons
Humana Healthy Horizons is more than a health plan. We're human care. Humana Healthy Horizons focuses on helping people achieve their best health. Our dedicated strategies across various markets and states are enabled by partnerships with state and local governments, community-based organizations, and national partners committed to removing barriers to helping people achieve their best health.
The Utilization Management (UM) Nurse uses clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations. The Utilization Management Nurse 2's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
About Humana
Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal opportunity and legal notices
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 protected veteran status.
It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
From Humana's careers page, first listed on Rolev.ai on November 6, 2026. Rolev.ai is not the employer.
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More at Humana
All Humana jobsCommon questions
What is the salary for the Utilization Management RN - Physical Health role at Humana?
The Utilization Management RN - Physical Health posting at Humana states compensation of $71,100 – $97,800 per year. Final pay may depend on location, experience, and interview evaluation on Humana's official career site.
Where is the Utilization Management RN - Physical Health job at Humana located?
Yes, this Utilization Management RN - Physical Health opening at Humana is listed as Remote (US). Always check Humana's application page for specific state eligibility or relocation policies.
How do I apply for the Utilization Management RN - Physical Health position at Humana?
This listing links directly to Humana's Workday application page. You can apply directly on Humana's site, or use Rolev.ai to check your resume fit, generate a zero-hallucination tailored resume and cover letter for this posting, and autofill the Workday application form in 1 click with the Rolev.ai Chrome extension. You always review the form and press Submit yourself.