Licensed Behavioral Health Utilization Management Professional 2 (Fully Remote)

Humana; United States; Remote; USD 90,000 - 110,000; Full time

Job summary

Humana is seeking a remote behavioral health clinician to support coordination, documentation, and communication of medical services and benefit determinations.

The role requires an active RN license or a master's in behavioral health with Louisiana licensure, plus 3+ years of clinical and behavioral health experience. Proficiency in MS Office and remote system navigation is essential; Louisiana residency is required with travel for trainings.

Qualifications

• Active RN license or master's degree in a behavioral health field with Louisiana professional license.
• 3+ years of post-degree clinical experience.
• 3+ years of behavioral health experience.
• Proficient with MS Office and able to navigate multiple systems in a remote environment.
• Remote position requiring residence in Louisiana, with occasional travel to Humana offices for training or meetings.
• Schedule is Monday through Friday, 8 AM to 5 PM Central Time with flexibility for Eastern Time and occasional weekends/holidays.

Responsibilities

• Support coordination, documentation, and communication of medical services and benefit administration determinations.
• Apply clinical knowledge and independent critical thinking to interpret criteria, policies, and procedures.
• Communicate with providers, members, and other parties to facilitate optimal care and treatment.

Education

RN license

Master's degree in behavioral health

Tools

MS Office

Job description

• Support coordination, documentation, and communication of medical services and benefit administration determinations.
• Apply clinical knowledge and independent critical thinking to interpret criteria, policies, and procedures.
• Communicate with providers, members, and other parties to facilitate optimal care and treatment.

Qualifications:

• Requires an active RN license or a master's degree in a behavioral health field with a Louisiana professional license.
• Must have 3+ years of post-degree clinical experience and 3+ years of behavioral health experience.
• Proficient with MS Office and able to navigate multiple systems in a remote environment.
• Remote position requiring residence in Louisiana, with occasional travel to Humana offices for training or meetings.
• Schedule is Monday through Friday, 8 AM to 5 PM Central Time with flexibility for Eastern Time and occasional weekends/holidays.

About Humana:

• Humana is a leading healthcare company focused on helping people achieve their best health through insurance and healthcare services.
• The culture emphasizes whole-person well-being and offers competitive benefits to support associates.

Humana

Humana is a leading U.S. healthcare company providing insurance services and healthcare through its CenterWell brand. It serves millions of people and fosters a caring, whole-person well-being culture.