Utilization Management RN (Discharge & Auth)

**Become a part of our caring community**

The Utilization Management Nurse 2 uses clinical nursing skills to support the coordination, documentation and communication of medical services and benefit administration determinations for Humana's Kentucky Medicaid Plan. You will perform medical necessity reviews, including initial and concurrent authorization decisions, using established clinical criteria and independent clinical judgment. The Utilization Management Nurse 2 also meaningfully contributes in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care.

The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills. These skills are used towards interpreting criteria, policies, and procedures. The goal is to provide the best and most appropriate treatment, care, or services for members.

+ Coordinate and communicate with providers, members, or...