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 robust 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. #J-18808-Ljbffr

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