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.
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📌 Remote Pre Authorization Nurse At Humana Newfoundland And Labrador
🏢 Humana
📍 Newfoundland and Labrador