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Remote Utilization Management RN - Medicaid Review

Remote / Online - Candidates ideally in
North Charleston, Charleston County, South Carolina, 29405, USA
Listing for: Humana
Remote/Work from Home position
Listed on 2026-08-09
Job specializations:
  • Healthcare
Salary/Wage Range or Industry Benchmark: 71000 - 98000 USD Yearly USD 71000.00 98000.00 YEAR
Job Description & How to Apply Below

Humana seeks an experienced Utilization Management Nurse, National Medicaid Clinical Operations, to review prior authorization requests for inpatient services. You’ll apply clinical guidelines, ensure medical necessity, and collaborate with healthcare providers and interdisciplinary teams.

The role reports to the Manager, Utilization Management and supports timely, compliant care. The position offers a typical Monday–Friday schedule with weekend coverage as needed, remote work, and a

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