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Remote Utilization Management RN | Medicaid Care Navigator
Remote / Online - Candidates ideally in
Stillwater, Payne County, Oklahoma, 74074, USA
Listed on 2026-08-10
Stillwater, Payne County, Oklahoma, 74074, USA
Listing for:
Humana
Remote/Work from Home
position Listed on 2026-08-10
Job specializations:
-
Healthcare
Healthcare Management
Job Description & How to Apply Below
Humana is seeking an Utilization Management Nurse, National Medicaid Clinical Operations, to review prior authorization requests for inpatient services. The role requires independent clinical judgment, collaboration with providers, and adherence to Medicaid policies and health plan requirements.
Responsibilities include clinical reviews, coordination with medical directors, documentation in EMR systems, and contributing to quality assurance and training initiatives.
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