Clinical UM Nurse

The Utilization Management Nurse interprets clinical criteria, policies, and procedures to provide appropriate treatment, care, or services for members. They coordinate with providers, members, and other parties to facilitate optimal care and treatment.

Location: Remote (US)

Salary: $71,100 - $97,800 per year

Responsibilities

• Interpret clinical criteria, policies, and procedures to provide appropriate treatment, care, or services for members.
• Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment.

Requirements

• Active Registered Compact Nurse license (RN) in the home state with no disciplinary action and ability to obtain non compact licensure.
• 3+ years of Medical Surgery, Heart, Lung or Critical Care Nursing clinical experience in Acute care (skilled or rehab clinical settings).
• Work rotation to include weekends and possible holiday coverage.
• Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting.
• Comprehensive knowledge of Microsoft Word, Outlook and Excel.

Benefits

• Competitive benefits supporting whole-person well-being, including medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, paid parental and caregiver leave.
• Short-term and long-term disability, life insurance.
• Bonus incentive plan based on company and/or individual performance.

Additional Information

• Work at Home requirements include a minimum internet speed of 25 Mbps download and 10 Mbps upload.
• Occasional travel to Humana's offices for training or meetings may be required.
• Application deadline: 08-01-2026.