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Remote Utilization Management Nurse — Medicaid Care Specialist
Remote / Online - Candidates ideally in
Virginia, St. Louis County, Minnesota, 55792, USA
Listed on 2026-08-12
Virginia, St. Louis County, Minnesota, 55792, USA
Listing for:
Humana
Remote/Work from Home
position Listed on 2026-08-12
Job specializations:
-
Nursing
Healthcare Nursing, RN Nurse
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 and assess medical necessity. The role collaborates with physicians, medical directors, and interdisciplinary teams to ensure compliant, timely care, reporting findings in EMR systems.
The position is remote with occasional travel to Humana offices for training; requires RN licensure and Medicaid experience.
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