Idaho State Job Bank is hiring: Post Acute Utilization Management Nurse (Intermo

Post Acute Utilization Management Nurse (Intermountain Region) at Humana in Boise, Idaho, United States Job Description 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 Post-Acute Utilization Management Nurse 2: + Review cases using 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. + Provider calls Use your skills to make an impact Required Qualifications + Licensed Registered Nurse (RN) in the appropriate state, with no disciplinary action + 2+ years of Post Acute clinical experience in a Skilled Nursing Facility, Inpatient Rehabilitation Facility, or Long-Term Acute Care facility) experience required + 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 Preferred Qualifications + Bachelor's degree in nursing (BSN) + Previous experience in Discharge Planning or Utilization Management + Experience working with Milliman MCG or CMS guidelines + Health Plan experience + Previous Medicare/Medicaid Experience a plus Work-At-Home Requirements To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + 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 + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job + Work from To view full details and how to apply, please login or create a Job Seeker account