Join Humana as a remote Pre-Authorization Nurse, dedicated to ensuring quality care for patients. Coordinate vital patient transfers and uphold documentation standards from your home office.

In this nursing role, you will focus on providing high-quality service for MHS beneficiaries outside the MTF. Your responsibilities include monitoring care, identifying improvements, and handling patient transfers effectively. You will engage with case reviews to ensure optimal discharge planning and connect with Tier III management for care continuity.

Key Responsibilities:
• Oversee patient care coordination and quality assurance
• Identify and document quality care concerns
• Process patient transfers with precise documentation




• Conduct thorough reviews of inpatient outlier cases
• Facilitate referrals to Tier III care management

Requirements:
• Current RN license and U.S. citizenship required
• Minimum of 3 years of clinical RN experience
• Proficiency in TRICARE and evidence-based criteria
• Strong attention to detail and precise documentation skills
• Capable of working effectively in a home setting

Bring your nursing skills to Humana to enhance patient care outcomes in this crucial role.
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📌 Quality-Focused Pre-Authorization Nurse Role (Newfoundland and Labrador)
🏢 Humana
📍 Newfoundland and Labrador