Remote Utilization Management RN – Medicaid Specialist
Remote / Online - Candidates ideally in
Elizabethtown, Hardin County, Kentucky, 42701, USA
Listed on 2026-08-08
Elizabethtown, Hardin County, Kentucky, 42701, USA
Listing for:
Humana
Remote/Work from Home
position Listed on 2026-08-08
Job specializations:
-
Nursing
Job Description & How to Apply Below
Humana seeks a qualified Utilization Management Nurse for National Medicaid Clinical Operations. The role reviews prior authorization requests for inpatient services, ensuring medical necessity and policy compliance while collaborating with clinicians and nonclinical staff.
Reports to the Manager, Utilization Management. The position requires RN licensure in Illinois (or willingness to obtain) and 3+ years of nursing experience, with expertise in Medicaid policies, EMR systems, and utilization
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