Remote Behavioral Health UM Specialist

Humana; United States; Remote; USD 65,000 - 89,000; Full time

Job summary

Humana is seeking a Licensed Behavioral Health Utilization Management Professional 2 to support coordination, documentation, and communication of medical services and benefit determinations. This remote role requires clinical knowledge, strong communication, and independent critical thinking to interpret criteria and policies.

Training is Monday through Friday, 8:00 AM–5:00 PM Central Time. After training, shift becomes Tuesday–Saturday 8:00 AM–5:00 PM Central Time, with occasional Eastern Time

Qualifications

• 3+ years of post-degree clinical experience in direct patient care.
• 3+ years of Behavioral Health experience.
• Proficient with MS Office, navigating multiple systems and platforms and general technical skills to troubleshoot and resolve within a remote environment.

Responsibilities

• Coordinate and communicate with providers and members to facilitate care.
• Interpret criteria, policies, and procedures to determine appropriate actions.
• Work independently to interpret standards and resolve ambiguous situations.

Skills

Clinical knowledge

Communication skills

Critical thinking

MS Office proficiency

Education

Master’s degree in a behavioral health–related field

Tools

MS Office

Job description

Humana is seeking a Licensed Behavioral Health Utilization Management Professional 2 to support coordination, documentation, and communication of medical services and benefit determinations. This remote role requires clinical knowledge, strong communication, and independent critical thinking to interpret criteria and policies.

Training is Monday through Friday, 8:00 AM–5:00 PM Central Time. After training, shift becomes Tuesday–Saturday 8:00 AM–5:00 PM Central Time, with occasional Eastern Time