Remote Behavioral Health UM Specialist

Humana Inc; Baton Rouge (LA); Remote; USD 65,000 - 89,000; Full time

Benefits offered by this job

Bonus incentive plan

Competitive benefits package

Language interpreter services

Job summary

Humana Inc. is seeking a Licensed Behavioral Health Utilization Management Professional 2 to support coordination, documentation and communication of medical services and benefit determinations.

The role involves interpreting criteria and policies to ensure the best care for members, with responsibilities spanning interaction with providers and internal teams. Candidates must hold an eligible behavioral health license or degree, have 3+ years of direct clinical experience, and be proficient in

Qualifications

• 3+ years of post-degree clinical experience in direct patient care.
• 3+ years of Behavioral Health experience
• Proficient with MS Office and navigating multiple systems and platforms in a remote environment.

Responsibilities

• Coordinate, document, and communicate care and benefit determinations.
• Interpret criteria, policies, and procedures to provide appropriate treatment options.
• Coordinate with providers, members, and other parties to facilitate optimal care.
• Follow established guidelines and procedures with minimal direction.

Skills

Clinical knowledge

Communication skills

Critical thinking

Education

RN / multi-state license

Master's in behavioral health field

LCSW / LMSW / LPC / LMFT / LAC / Psychologist license

Tools

MS Office

Remote work tools

Job description

Humana Inc. is seeking a Licensed Behavioral Health Utilization Management Professional 2 to support coordination, documentation and communication of medical services and benefit determinations.

The role involves interpreting criteria and policies to ensure the best care for members, with responsibilities spanning interaction with providers and internal teams. Candidates must hold an eligible behavioral health license or degree, have 3+ years of direct clinical experience, and be proficient in