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Why this grade This listing scored 34/100, which is an F. It lost the most ground on pay transparency. See the breakdown
- Description depth 20 / 20 How much the posting actually says about the work, measured in characters of real text.
- Pay transparency 12 / 25 A published salary range, worth more than any other single factor because it is what a candidate cannot find out without applying.
- Remote clarity 8 / 15 Whether "remote" means anywhere, or is quietly restricted to one country.
- Corroboration 5 / 10 Whether more than one source carries this listing.
- Freshness 4 / 15 How recently it was posted. Older postings are likelier to be filled or abandoned.
- Role specificity 0 / 10 Whether the listing is tagged well enough to tell what the role actually is.
-15 Ghost-job penalty — Deducted for signals that this posting may not be a real, currently-open role — staleness, repeated relisting, or talent-pool language.
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The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Reports to the UM Nurse, ManagerThe Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
Use your skills to make an impact
Required Qualifications
Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care, skilled, long term care or rehabilitation setting
Licensed Practical Nurse (LPN) with at least 5 years of clinical experience in acute care, skilled, long term care or rehabilitation setting.
MUST reside in the state of FLORIDA
License in the state of Florida with no disciplinary action
Preferred Qualifications
BSN or Bachelors degree in a related field
Prior experience in utilization management/review and or prior authorizations.
Background in case management for Long-Term Services and Supports (LTSS) members.
Experience with MCG guidelines
Experience evaluating requests for durable medical equipment.
Familiarity with health plan operations.
Additional Information
- Must work an 8 hour shift between 8:30AM-5:30PM local time Monday-Friday
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$71,100 - $97,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Originally posted on Himalayas
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Where this listing came from
- 03 Aug 2026 Himalayas first sighting
Seen on 1 board over 0 days.