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Remote Medicaid Utilization Review RN
Remote / Online - Candidates ideally in
Sumter, Sumter County, South Carolina, 29153, USA
Listed on 2026-08-08
Sumter, Sumter County, South Carolina, 29153, USA
Listing for:
Humana
Full Time, Part Time, Remote/Work from Home
position Listed on 2026-08-08
Job specializations:
-
Healthcare
Healthcare Administration
Job Description & How to Apply Below
Humana is seeking a Prior Authorization Nurse for National Medicaid Clinical Operations. The role evaluates outpatient prior authorization requests, ensuring medical necessity and policy compliance, while coordinating with providers and teams to enable timely care.
The position requires licensure in Illinois to support state programs, with remote work options and occasional travel to Humana offices for training. 40 hours weekly, Monday–Friday, with weekend coverage as needed.
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