ONLY **Role: **Front End Review, RN (FER) Assignment: Full-Time Flexible Weekend Schedule **Location: **Florida WAH ONLY - Humanas dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor. Humanas Perfect Service® means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members. We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares. Assignment Capsule Be a part of our Clinical Space as a Clinical Advisor you will engage our members to develop lifelong wellbeing and health. Humana is seeking a Clinical RN Advisor who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines review criteria. * Manage network participation, care with specialty networks, care with DME providers and transfers to alternative levels of care using your knowledge of benefit plan design * Recommend services for Humana Plan members utilizing care alternatives available within the community and nationally * Identify potentially unnecessary services and care delivery settings, and recommend alternatives if appropriate by analyzing clinical protocols * Examine clinical programs information to identify members for specific case management and / or disease management activities or interventions by utilizing established screening criteria * Conduct admission review, post-discharge calls and discharge planning Role Essentials * Active unrestricted RN license in the state of Florida and ability to be licensed in multiple states without restrictions * Prior clinical experience in an acute care, skilled or rehabilitation clinical setting * Ability to work independently under general instructions and with a team * Proficient with MS Office Products to include Word, Excel, Outlook, and multiple systems **Additional Requirements: ** * Must have a separate room for privacy with a locked door during working hours and during communication with members. * Must provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service are prohibited). A minimum standard speed of10x1 (10mbs download x 1mbs upload) for optimal performance of is required * Valid drivers license and/or dependable transportation necessary Role Desirables * Education: BSN or Bachelors degree in a related field * 3 years prior clinical experience in an acute care, skilled, or rehabilitative setting * 3 years year Utilization, case management experience, discharge planning and/or home health rehab * Health Plan experience * Previous Medicare/Medicaid Experience a plus * Call center or triage experience * Bilingual is a plus Additional Information Humana is an organization with careers that change livesincluding yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If youre ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you. Apply now, or join our Talent Network so you can stay informed and up to date on whats happening at Humana. **Primary Location: **US-FL-Tampa **Work Locations: ** **Organization: **Humana Inc **Schedule: **Full-time **Travel: **Yes, 5 % of the Time