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Remote Prior Authorization RN – Utilization Review

Remote / Online - Candidates ideally in
Aurora, Kane County, Illinois, 60505, USA
Listing for: Humana
Remote/Work from Home position
Listed on 2026-08-09
Job specializations:
  • Healthcare
    Healthcare Administration
Salary/Wage Range or Industry Benchmark: 71000 - 98000 USD Yearly USD 71000.00 98000.00 YEAR
Job Description & How to Apply Below

Humana in Illinois is seeking a Prior Authorization Nurse for National Medicaid Clinical Operations to review clinical documentation and determine medical necessity for outpatient services, ensuring compliance with health plan policies and regulations. You will collaborate with providers and interdisciplinary teams, document decisions in EMR systems, and contribute to quality assurance and performance improvement projects.

This is a remote position with occasional travel to Humana offices.

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