Run - Toxic WFH team - Nurse Auditor Humana Employee Review

1.0
Feb 9, 2025
Recommend
CEO approval
Business Outlook

Pros

You get to work from home and can choose your hours from 6am to 6pm (8 hours). Sometimes your manager is nice when they feel like it.

Cons

Constant micromanaging Management lies about metrics and what is expected from an auditor. They tell you about how it's 5 claims a day but won't tell you that it can take up to hours to complete each claim (and that each claim only counts as one. Period. No excuses or rationale excepted). They will tell you that everyone else is meeting metrics, except you. The training was a few weeks and then you're told not to contact your trainer because it bugs them/bogs them down. You are constantly told you are not good enough in HR-appropriate language. Your co-workers act nice to your face then turn around and tattletale on you to your manager that you are taking time away from them meeting metrics. You are given higher complex claims compared to offshore RN's (and the offshore RN's have lower standards for auditing, quality auditing doesn't matter for them, and they get to mess up and not get fired or written up/coached). SMEs will give you absolutely the worst claims to complete knowing you will not be able to complete them within an hour. You are told to reach out to your manager for any help/assistance, but when you do reach out, they tell you they cannot help you. The SMEs are constantly subjective with a lot of their reviews on your claims and are never wrong (they and the managers will never admit that they were wrong). You will be gaslit the entire time with your concerns, and then before you know it, you will be coached (for a paper trail) and given no solutions to help you meet metrics. Also, the managers are so out of touch with reality on how complex a sepsis claim is (with 4-6 diagnoses within the claim on average with hundreds of pages to review) that they'll tell you it's "easy to do and strait forward to complete" on any claim within an hour. The same managers admit that they haven't reviewed or written up a claim in years. If anyone is reading this? Run. Do not work for Humana. The pay is a low as they will go (Even lower than the job advertises) and they will work you until you are a husk. I've worked multiple jobs as an auditor and thought Humana was better than this. I was wrong.

Explore other reviews about Humana

5.0
May 7, 2026
Recommend
CEO approval
Business Outlook

Pros

Awesome company with best industry standards

Cons

Nothing I could notice , very good company

1.0
Jun 22, 2026
Recommend
CEO approval
Business Outlook

Pros

Working from home, that’s about it.

Cons

Micromanaging, forced to help team members while you’re behind on your own caseload. Denied PTO requests, no PTO all summer and no PTO until the end of January 2027 (that’s supposed supposedly when they will be done ramping up with all their new employees.) a bunch of meetings weekly that are pointless. A weekly case conference where they are forcing nurses to present a complex case in front of over 300 people on zoom. Process changes change constantly, there are no job aid or guideline that help you make a Clinical decision but you will get out of it if you do it incorrectly. Save yourself the trouble and apply somewhere else. It is not worth it.

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