Impact patient care as a remote Pre-Authorization Nurse with Humana. Engage in patient coordination, ensuring high-quality care and managing transfers while working from home. As a Pre-Authorization Nurse, you will report directly to a Supervisor and support MHS beneficiaries receiving external care.

Your role encompasses quality monitoring and case reviews, ensuring that discharge planning aligns with Tier III criteria. You’ll play a crucial part in maintaining documentation and facilitating smooth patient transitions for optimal care. Key Responsibilities:

- Coordinate patient care for MHS beneficiaries
- Monitor and document care quality issues
- Manage patient transfer documentation in MSR
- Review inpatient outlier cases diligently
- Refer cases to Tier III management as needed Requirements:
- Must be a U.S. citizen for security clearance
- RN license with 3+ years clinical experience
- Experience with TRICARE and MCG criteria
- Utilize solid analytical and communication skills
- Ability to work independently in a remote setup Utilize your nursing expertise to improve patient outcomes with Humana's supportive care model now.

📌 Remote Pre-Authorization Nurse at Humana (Dover)
🏢 Humana
📍 Dover