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This position was posted on February 27, 2026 and is likely no longer accepting applications. We've kept it here for historical reference. Check out the similar jobs below!

RN, Clinical Nurse

Humata Health Inc.

Job Overview

Location

Remote | US

Job Type

Full-time

Full Job Description

📋 Description

• Humata Health Inc. is at the forefront of revolutionizing healthcare through the innovative application of Artificial Intelligence (AI). We are seeking a highly skilled and motivated Clinical Nurse (RN) to join our dynamic team, playing a pivotal role at the intersection of cutting-edge technology and clinical practice. This unique opportunity is designed for a seasoned nurse who is eager to leverage their clinical expertise to enhance the efficiency, accuracy, and reliability of healthcare processes, specifically within the realm of prior authorization and utilization review.
• In this critical role, you will be instrumental in bridging the gap between clinical realities and AI-driven solutions. A significant aspect of your work will involve close collaboration with our clients, primarily utilization review nurses within health plans. Your primary objective will be to ensure that our AI systems are not only accurately supporting medical necessity decisions but also effectively streamlining the prior authorization process. This involves a deep dive into the nuances of medical policies, where you will contribute to digitizing these policies so that our AI can interpret, apply, and enforce them with unparalleled consistency and precision.
• Your clinical judgment will be paramount in validating and refining the AI's outputs. You will apply your extensive knowledge of evidence-based guidelines, payer standards, and established medical coding practices to ensure that the AI's recommendations and decisions align perfectly with current healthcare best practices and regulatory requirements. This hands-on validation process is crucial for building trust and ensuring the efficacy of our AI tools.
• Beyond direct AI validation, this position demands strong project management capabilities. You will be tasked with coordinating complex policy digitization efforts, meticulously tracking progress across multiple health plans, and managing intricate timelines and deliverables. This requires seamless coordination with various cross-functional teams, including product managers, engineers, and client stakeholders, ensuring that all parties are aligned and working towards common goals.
• You will act as a vital conduit between the clinical world and our product development teams. By providing invaluable feedback during product review cycles, you will offer insights on usability, accuracy, and workflow alignment from a clinician's perspective. Furthermore, you will proactively guide our product and engineering teams by translating complex clinical and utilization review needs into clear, actionable product requirements. This ensures that the technology we build is not only sophisticated but also practical and directly addresses the real-world challenges faced by healthcare professionals.
• Your responsibilities will extend to the rigorous testing and validation of our AI-enabled review tools. You will be involved in continuous improvement initiatives, meticulously testing for accuracy, fairness, and potential biases. Your feedback will be instrumental in enhancing both the policy digitization workflows and the AI-driven decision support mechanisms, driving iterative improvements that elevate the performance and reliability of our platform.
• Staying abreast of the ever-evolving landscape of healthcare is essential. You will be expected to maintain current knowledge of payer requirements, clinical guidelines, regulatory standards, and medical coding updates relevant to utilization management. This continuous learning ensures that our AI systems remain compliant and effective in a dynamic environment.
• The role also involves managing small-scale projects, which includes organizing digitization initiatives, meticulously tracking timelines, coordinating diverse stakeholders, and providing clear, concise progress reports. This requires a proactive and organized approach to project execution.
• Ultimately, your contribution will be central to Humata Health's mission: to leverage clinical expertise and advanced AI to make prior authorization faster, smarter, and more reliable, thereby improving healthcare efficiency and patient outcomes. This is an exceptional opportunity to make a tangible impact on the future of healthcare technology and delivery.

🎯 Requirements

• Registered Nurse (RN) with an active, unrestricted license in the United States.
• Minimum of 3 years of progressive experience in utilization management, prior authorization, case management, or closely related clinical roles within a healthcare setting.
• Demonstrated strong understanding of payer policies, medical necessity criteria, and the intricacies of the prior authorization process.
• Working knowledge of essential medical coding systems, including ICD-10, CPT, and HCPCS.
• Proven project management skills, including the ability to organize complex workflows, manage multiple deliverables, track timelines, and ensure accountability across cross-functional teams.
• Excellent critical thinking, analytical, and problem-solving abilities, with a keen eye for detail and accuracy.
• Strong written and verbal communication skills, with the ability to effectively collaborate with both clinical and technical professionals.

🏖️ Benefits

• Competitive base compensation, complemented by an equity stake through our Employee Stock Option Plan (ESOP).
• Comprehensive health benefits package, including medical, dental, and vision insurance.
• Generous Paid Time Off (PTO) policy, offering unlimited flexibility for time off.
• 401k retirement savings plan with a valuable employer match.
• Fully remote work arrangement, providing flexibility and work-life balance, with an optional hybrid option available in Orlando, FL.
• Significant opportunities for professional growth and career advancement within a rapidly expanding, innovative health tech company.

Skills & Technologies

Remote

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Humata Health Inc.

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About Humata Health Inc.

Humata Health provides AI-driven prior authorization automation for healthcare providers and payers. The platform uses machine learning to analyze clinical documentation, predict authorization requirements, and auto-populate payer forms, reducing manual effort and accelerating patient access to care. Integrations with EHRs and payer systems streamline workflows, cut administrative costs, and improve approval turnaround times. Target customers include health systems, hospitals, and specialty practices seeking to offload prior authorization burdens and enhance revenue cycle efficiency.

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