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Pre-Authorization Nurse

Company

Humana

Location

Providence, RI

Posted

June 06, 2026

Position Overview

**Become a part of our caring community**
As a remote Pre-Authorization Nurse, you will report to a Supervisor of Pre-Authorization Nursing. You will coordinate care for MHS beneficiaries receiving care outside the MTF. You will monitor quality of care, identify, and document any potential quality issues regarding the patient's care. You will coordinate patient transfers and document in MSR. Review inpatient outlier cases, ensure appropriate discharge planning, and refer to Tier III care management as needed.
As a remote Pre-Authorization Nurse, you will report to a Supervisor of Pre-Authorization Nursing. You will coordinate care for MHS beneficiaries receiving care outside the MTF. You will monitor quality of care, identify, and document any potential quality issues regarding the patient's care. You will coordinate patient transfers and document in MSR. Review inpatient outlier cases, ensure appropriate discharge planning, and refer to Tier III care management as needed.
**U...

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