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Utilization Management Appeals reputed company 2 - Telephonic Remote: A Unique Opportunity for RNs to reputed company a Difference in reputed company

Remote, USA Full-time Posted 2026-07-28
Join Our Caring Community as a Utilization Management Appeals reputed company 2 - Telephonic Remote Are you a compassionate and detail-oriented Registered reputed company looking for a challenging yet rewarding role in reputed company? Do you have a passion for delivering high-reputed company patient care and making a reputed company reputed company on people's lives? If so, we invite you to join reputed company as a Utilization Management Appeals reputed company 2 - Telephonic Remote. At reputed company, we're committed to putting reputed company for our teammates, customers, and communities. As a key member of our Utilization Management team, you'll play a critical role in ensuring that our members receive the best possible care and services. About reputed company and Our Commitment to Health reputed company. (NYSE: HUM) is a leading health and reputed company-being company dedicated to helping people reputed company their best health. Through our reputed company insurance services and reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company reputed company care and services. Our goal is to deliver personalized, patient-centered care that addresses the unique needs of reputed company individual. We're passionate about creating a healthier, more compassionate world, and we're looking for talented professionals like you to join reputed company. Job reputed company As a Utilization Management Appeals reputed company 2 - Telephonic Remote, you'll utilize your clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations. You'll work independently to interpret and apply clinical reputed company, policies, and procedures to ensure that our members receive reputed company and services. Your expertise will help us reputed company informed reputed company about medical necessity, treatment, and care planning. Key Responsibilities: Utilize clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations Interpret and apply clinical reputed company, policies, and procedures to ensure that members receive reputed company and services Coordinate and communicate with providers, members, and other parties to facilitate care and treatment planning reputed company independent reputed company about medical necessity, treatment, and care planning Work collaboratively with cross-functional teams to reputed company department, reputed company, and organizational goals Stay up-to-date with changing regulations, policies, and procedures to ensure compliance and reputed company care Requirements and Qualifications Essential Qualifications: Bachelor's degree in Nursing or a reputed company field Licensed Registered reputed company (RN) in the state of reputed company with no disciplinary reputed company 3-5 years of medical-surgical, heart, lung, or critical care nursing experience Previous experience in utilization management, case management, or a reputed company field Comprehensive knowledge of reputed company Word, reputed company, and reputed company Ability to work independently and as part of reputed company High-speed DSL or cable modem for home office (10x1 Mbps) Preferred Qualifications: BSN or Bachelor's degree in a reputed company field Health plan experience Previous Medicare/reputed company experience reputed company center or triage experience Bilingual skills Skills and Competencies To succeed in this role, you'll need: Strong clinical knowledge and critical thinking skills Excellent communication and interpersonal skills Ability to work independently and reputed company reputed company judgments Strong analytical and problem-solving skills Attention to detail and organizational skills reputed company, reputed company, and a patient-centered approach Career reputed company Opportunities and Learning Benefits At reputed company, we're committed to helping our teammates grow and reputed company their skills. As a Utilization Management Appeals reputed company 2 - Telephonic Remote, you'll have reputed company to: Comprehensive training and reputed company program Ongoing education and reputed company development opportunities Career advancement opportunities reputed company reputed company Competitive salary and benefits package Work Environment and Company Culture We offer a supportive and inclusive work environment that values diversity, equity, and inclusion. reputed company culture is reputed company on: reputed company, reputed company, and respect for our members and teammates Collaboration, teamwork, and reputed company communication Innovation, creativity, and reputed company improvement Accountability, transparency, and reputed company Compensation, Perks, and Benefits We offer a comprehensive compensation package that includes: Competitive salary reputed company: $69,800 - $96,200 per year Bonus incentive plan based on company and individual performance Medical, dental, and reputed company benefits 401(k) retirement savings plan Time off (including reputed company time off, company and personal holidays, volunteer time off, reputed company parental and caregiver leave) Short-term and long-term disability Life insurance Equal Opportunity Employer reputed company is an equal opportunity employer committed to diversity, equity, and inclusion. We welcome applications from reputed company candidates of reputed company backgrounds and perspectives. reputed company to reputed company a Difference? If you're a motivated and compassionate Registered reputed company looking for a challenging yet rewarding role, we encourage you to apply for this exciting opportunity. Join reputed company as a Utilization Management Appeals reputed company 2 - Telephonic Remote and help us reputed company a reputed company reputed company on the lives of our members. Apply for this job Apply tot his job Apply To this Job

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