Become a part of our caring community and help us put health first

Humana Healthy Horizons in Oklahoma is seeking a RN, Utilization Management (UM) Nurse 2 who will use their clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations. The RN, Utilization Management Nurse 2 works on assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action.

• Coordinates and communicates with Internal Medical Directors, Providers, Enrollees, or other parties to facilitate optimal care and treatment.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Uses clinical knowledge, communication skills, and independent critical thinking skills toward interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care, or services for Enrollees.
• Makes decisions regarding own work methods, occasionally in ambiguous situation, requiring minimal direction and receiving guidance where needed.
• Follows established guidelin...