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Utilizatation Management Nurse 2 (Weekend) - Florida

Company: Humana
Location: Port Saint Lucie
Posted on: October 24, 2018

Job Description:

Description 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. Responsibilities 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. + This is a weekend position, the work schedule is four (4), ten (10) hour days, Saturday - Tuesday, 8:00am - 6:30pm or 7:30am - 6pm Eastern Standard Time (EST). Required Qualifications + Active RN licensed without restrictions. + Ability to be licensed in multiple states without restrictions. + Prior clinical experience an acute care, skilled or rehabilitation clinical setting. + Experience in Utilization Management, Medicare and/or Medicaid guidelines. + Excellent computer and communication skills. + Ability to work independently under general instructions and with a team. + 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 10x1 (10mbs download x 1mbs upload) is required. Preferred Qualifications + Health Plan experience + Bilingual is a plus Additional Information As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, 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 Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. 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 mailbox_tas_recruit@humana.com for assistance.

Keywords: Humana, Port St. Lucie , Utilizatation Management Nurse 2 (Weekend) - Florida, Executive , Port Saint Lucie, Florida

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