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Manager, RN Prior Authorization, Louisville Kentucky Office

Humana Louisville Full-Time
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Required Qualifications

Licensed Registered Nurse (RN) in the state of Kentucky with no disciplinary action and ability to be licensed in multiple states without restriction.

2+ years of management/leadership, project lead or subject matter expert experience

2+ Progressive clinical experience preferably in an acute care, skilled or rehabilitation clinical setting

Strong Proficiency with MS Office Suite to include Word, Excel, Power Point,

6+ years Technical experience aptitude to troubleshoot and resolve system platform and connectivity problems

Experience with the development and implementation of policies and procedures

Ability to work independently under general instructions and with a team

Additional Requirements:

Hours: Typically Monday-Friday 8:00 AM - 5:00 PM with rotating on-call coverage and oversight during weekends and holidays.

Location: Louisville Kentucky office

Valid driver's license, car insurance, and access to an automobile

This role is a part of Humana's Driver Safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

This role may require travel about 5%-25% of the time, which is about 2-8 times monthly.

This is a patient facing position and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to complete a test for TB in the event member facing is required.

Completion of a Level II; AHCA Fingerprinting

Preferred Qualifications

Bachelor's Degree

Prior supervisory experience hiring, training, coaching, and termination

1+ year Care Management experience in an acute care, skilled or Rehabilitation clinical setting

Health Plan experience

Medicaid experience

Call center or triage experience

Bilingual is a plus

Additional Information:

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.


Recommended skills

Acute Care
Microsoft Excel
Registered Nurse Certified
Microsoft Power Point
Health Policies


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Manager, RN Prior Authorization, Louisville Kentucky Office
Estimated Salary: $87K
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Job ID: R-220418


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