Post Acute Utilization Management Nurse

4 weeks ago


Santa Fe, New Mexico, United States Humana Full time
Job Summary

Become a part of our caring community and help us put health first. As a Utilization Management Nurse, you will utilize your clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.

Key Responsibilities
  • Review cases using clinical knowledge, communication skills, and independent critical thinking skills to interpret criteria, policies, and procedures.
  • Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment.
  • Use your skills to make an impact and contribute to an organization focused on continuously improving consumer experiences.
Requirements
  • Licensed Registered Nurse (RN) in the appropriate state, with no disciplinary action.
  • 2+ years of Post Acute clinical experience in a Skilled Nursing Facility, Inpatient Rehabilitation Facility, or Long-Term Acute Care facility.
  • Comprehensive knowledge of Microsoft Word, Outlook, and Excel.
  • Ability to work independently under general instructions and with a team.
Preferred Qualifications
  • Bachelor's degree in nursing (BSN).
  • Previous experience in Discharge Planning or Utilization Management.
  • Experience working with Milliman MCG or CMS guidelines.
  • Health Plan experience.
  • Previous Medicare/Medicaid Experience a plus.
Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended.
  • Wireless, wired cable, or DSL connection is suggested.
  • Satellite, cellular, and microwave connection can be used only if approved by leadership.
About Humana

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.


  • Post Operations Nurse

    4 weeks ago


    Santa Fe, New Mexico, United States All Medical Personnel Full time

    Job Title: Post Operations NurseJob Summary:As a Post Operations Nurse with All Medical Personnel, you will provide intensive care to patients as they awaken from anesthesia after a surgical procedure. Your significant experience in a medical-surgical environment or in emergency medicine will enable you to identify complications and intervene...


  • Santa Fe, New Mexico, United States CHRISTUS Health Full time

    Job SummaryWe are seeking a highly skilled Registered Nurse to join our team in the Post Anesthesia Care Unit (PACU). The successful candidate will be responsible for providing exceptional patient care and supervision to a team of nurses.Key ResponsibilitiesDirect and provide professional post anesthesia nursing care for an assigned group of patients across...

  • Case Manager

    4 weeks ago


    Santa Fe, New Mexico, United States CHRISTUS Health Full time

    Job SummaryAs a Case Manager with CHRISTUS Health, you will play a vital role in ensuring patient progression through the continuum of care in an efficient and cost-effective manner. In collaboration with patients, families, physicians, and the interdisciplinary team, you will identify, initiate, and manage optimal patient flow/throughput to enhance...

  • Travel Nurse RN

    4 weeks ago


    Santa Fe, New Mexico, United States MedPro Healthcare Staffing Full time

    Job Title: Travel Nurse RN - Post Anesthesia Care SpecialistJob Summary:MedPro Healthcare Staffing is seeking a skilled travel nurse RN to work in a Post Anesthesia Care Unit (PACU) setting. The ideal candidate will have experience in recovering patients from anesthesia and monitoring their vital signs.Responsibilities:Assist in recovering patients from...

  • Case Manager

    4 weeks ago


    Santa Fe, New Mexico, United States CHRISTUS Health Full time

    Job SummaryCHRISTUS Health seeks a skilled Case Manager to join our team. As a Case Manager, you will be responsible for ensuring patient progression through the continuum of care in an efficient and cost-effective manner.Key ResponsibilitiesCollaborate with patients, families, physicians, and interdisciplinary teams to identify and manage optimal patient...


  • Santa Fe, New Mexico, United States Compass Group, North America Full time

    Job SummaryWe are seeking a Clinical Nutrition Manager to lead our nutrition team in an acute care setting. This role is responsible for establishing goals and coordinating implementation of clinical nutrition care based upon the facility's medical direction and patient population.Key Responsibilities:Assess the nutritional status of patients through...

  • Travel Nurse RN PACU

    4 weeks ago


    Santa Fe, New Mexico, United States LanceSoft Full time

    LanceSoft is seeking a skilled travel nurse RN for a PACU - Post Anesthesia Care position in a dynamic healthcare setting.Job Details: Specialty: PACU - Post Anesthesia CareShift: 12 hours, daysEmployment Type: TravelAs a travel nurse RN with LanceSoft, you will have the opportunity to work in a variety of healthcare settings and gain valuable experience in...


  • Santa Fe, New Mexico, United States TotalMed Staffing Full time

    About the Role:As a Post Anesthesia Registered Nurse with TotalMed Staffing, you will be responsible for providing exceptional care to patients in the post-anesthesia care unit (PACU). Your role will involve monitoring vital signs, managing pain, and offering support during the post-anesthesia period.Key Responsibilities:Provide post-operative care for...


  • Santa Fe, New Mexico, United States TotalMed Staffing Full time

    About the Role:We are seeking a skilled Registered Nurse to join our team in the Post Anesthesia Care Unit. As a Post Anesthesia Registered Nurse, you will be responsible for providing high-quality patient care to patients recovering from anesthesia.Key Responsibilities:Monitor vital signs and assess patients' conditionsManage pain and discomfortCollaborate...

  • Travel Nurse RN

    4 weeks ago


    Santa Fe, New Mexico, United States MedPro Healthcare Staffing Full time

    Job Description & RequirementsMedPro Healthcare Staffing is seeking a highly skilled travel nurse RN to join our team in a Post Anesthesia Care Unit (PACU) setting.Specialty: PACU - Post Anesthesia CareDiscipline: RNEmployment Type: TravelAs a travel nurse RN in our PACU, you will be responsible for providing high-quality patient care to patients recovering...


  • Santa Fe, New Mexico, United States Travel Nurse Across America Full time

    Job Summary:We're seeking a skilled Medical Surgical Travel Nurse to join our team at Travel Nurse Across America. As a MedSurg RN, you will conduct patient assessments, prioritize data collection, and provide ongoing care as ordered by a physician. Documenting patient findings and educating patients' families is essential to this role.Key...


  • Santa Fe, New Mexico, United States Fusion Medical Staffing Full time

    Make a Positive Impact with Fusion Medical StaffingWe're looking for a dedicated and compassionate Registered Nurse to join our team as a Post-Anesthesia Care Nurse. As a valued member of our team, you'll have the opportunity to make a positive impact on the lives of our patients and their families.Benefits of Working with Fusion Medical StaffingCompetitive...


  • Santa Fe, New Mexico, United States Fusion Medical Staffing Full time

    Make a Positive Impact with Fusion Medical StaffingAt Fusion Medical Staffing, we're dedicated to improving the lives of everyone we touch. As a Post-Anesthesia Care Nurse, you'll play a vital role in helping patients recover from anesthesia and surgery. Join our team and gain access to competitive pay packages, comprehensive benefits, and a supportive...


  • Santa Fe, New Mexico, United States Morrison Healthcare Full time

    Job OverviewMorrison Healthcare is seeking a highly skilled Clinical Nutrition Manager to lead our nutrition team in an acute care setting in Santa Fe, NM.Key Responsibilities:Develop and implement clinical nutrition care plans based on the facility's medical direction and patient population.Assess the nutritional status of patients through documentation in...


  • Santa Fe, New Mexico, United States OneStaff Medical Full time

    We are seeking a skilled Travel Post-Anesthesia Recovery Nurse to provide exceptional care for post-operative patients recovering from anesthesia. As a PACU RN, you will be responsible for monitoring vital signs and providing necessary care to inpatients and outpatients. This role requires a high level of attention to detail and the ability to work...


  • Santa Fe, New Mexico, United States MLee Healthcare Staffing and Recruiting, Inc Full time

    Post-Anesthesia Care Unit Registered Nurse PositionMLee Healthcare Staffing and Recruiting, Inc is seeking a full-time, permanent Registered Nurse (RN) to join our client's Post-Anesthesia Care Unit (PACU) at a premier healthcare facility near Santa Fe, NM.Key Responsibilities:• Provide exceptional post-anesthesia care, focusing on patient safety and...


  • Santa Fe, New Mexico, United States Della Infotech Full time

    Job Summary: We are seeking a skilled Registered Nurse to join our team as an Acute Rehabilitation Registered Nurse. The ideal candidate will have a minimum of 1 year of experience in acute rehabilitation and be licensed to practice in New Mexico or a compact state. Responsibilities: • Provide high-quality patient care in an acute rehabilitation setting...

  • Nurse Practitioner

    4 weeks ago


    Santa Fe, New Mexico, United States Christus Health Full time

    Job SummaryWe are seeking a skilled Registered Nurse to join our team in the Post Anesthesia Care Unit (PACU). The successful candidate will provide professional nursing care to patients across the age continuum, utilizing the nursing process to assess, plan, implement, and evaluate care.ResponsibilitiesDirect and provide post anesthesia nursing care to...


  • Santa Fe, New Mexico, United States Travel Nurse Across America Full time

    Oncology Travel Nurse OpportunityWe're seeking a skilled Oncology Registered Nurse to join our team at Travel Nurse Across America. As an Oncology Travel Nurse, you'll provide top-level care for critically or chronically ill cancer patients in Santa Fe, NM. Under direction from a physician, you may administer chemotherapy, implement new methods of symptom...

  • Travel Nurse RN

    4 weeks ago


    Santa Fe, New Mexico, United States MedPro Healthcare Staffing Full time

    Job Description & RequirementsMedPro Healthcare Staffing is seeking a travel nurse RN for a post anesthesia care specialist role in a top healthcare facility.Specialty: PACU - Post Anesthesia CareDiscipline: RNDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelAs a post anesthesia care specialist, you will assist in recovering...