Healthcare Specialist

2 weeks ago


Baton Rouge, Louisiana, United States Humana Full time
About the Role

We are seeking a skilled Pre-Authorization Nurse to join our team in Louisiana. This is a remote opportunity that requires a high-speed internet connection and a dedicated workspace.

The successful candidate will review prior authorization requests, follow guidelines and policies, and approve services or forward requests to the appropriate stakeholder. A moderate level of complexity is expected in this role.

Key Responsibilities
  • Completes medical necessity and level of care reviews for requested services using clinical judgment
  • Refers to internal stakeholders for review depending on case findings
  • Enters and maintains pertinent clinical information in various medical management systems
Requirements
  • Active RN license in the state of Louisiana
  • Ability to be licensed in multiple states without restrictions
  • 3 or more years varied nursing experience
  • Proficient with MS Office products including Word, Excel, and Outlook
Salary and Benefits

The compensation range for this position is $69,800 - $96,200 per year. Humana offers a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, and short-term and long-term disability insurance.



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