Clinical UM Nurse 2 Position Available In Essex, Massachusetts

Job Listing ID:

4291389

Job Title:

Clinical UM Nurse 2

Application Deadline:

Open Until Filled

Job Location:

Salem

Date Posted:

06/14/2025

Hours Worked Per Week:

Not Provided Shift:

Not Provided Duration of Job:

Either Full or Part Time, more than 6 months You may contact this employer directly.
(Obtain the contact information to print or add to your jobs.)

Job Summary:

Become a part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Licensed Registered Compact Nurse license (RN) with no disciplinary action and ability to obtain non compact licensure 3 – 5 years of Medical Surgery, Heart, Lung or Critical Care Nursing experience required Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting Comprehensive knowledge of Microsoft Word, Outlook and Excel Ability to work independently under general instructions and with a team Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required Must be passionate about contributing to an organization focused on continuously improving consumer experiences Must be willing to be in weekend rotation and possible holiday coverage. Preferred Qualifications 3 or more years experience in a high-volume community or mail order pharmacy practice environment Previous experience in utilization management

Education:

BSN or Bachelor’s degree in a related field Health Plan experience Previous Medicare/Medicaid Experience a plus Call center or triage experience Bilingual is a plus

Travel:

While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 – $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company a…

Job Classification:

Registered Nurses Access our statewide or regional occupation report for more information about wages,
employment outlooks, skills, training programs, related occupations, and more. Compensation

Salary:

Not Provided Job Requirements

Experience Required:

 See Job Summary

Education Required:

None

Minimum Age:

N/A Gender:

N/A