Remote Behavioral Health Utilization Management Specialist

Humana Inc; Louisiana (MO); Hybrid; USD 65,000 - 89,000; Full time

Benefits offered by this job

Remote work

Job summary

Humana Inc. in the United States seeks a Licensed Behavioral Health Utilization Management Professional 2 to coordinate clinical determinations, documentations, and communication across care teams while interpreting criteria and policies to support members.

This remote role requires Louisiana licensure options, 3+ years of post-degree clinical and behavioral health experience, and the ability to work within a central time zone schedule; travel minimal.

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, document, and communicate medical services and benefit determinations.
• Interpret criteria, policies, and procedures to provide appropriate treatment, care or services for members.
• Collaborate with providers, members, or other parties to facilitate optimal care and treatment.
• Make decisions regarding own work methods with minimal direction in ambiguous situations.

Skills

Clinical experience

Behavioral health experience

MS Office proficiency

Education

RN multi-state compact OR Masters in behavioral health-related field with license

Licensed Clinical Social Worker (LCSW)

Licensed Master Social Worker (LMSW)

Licensed Professional Counselor (LPC)

Licensed Marriage and Family Therapist (LMFT)

Licensed Addiction Counselor (LAC)

Licensed Psychologist

Tools

MS Office

Job description

Humana Inc. in the United States seeks a Licensed Behavioral Health Utilization Management Professional 2 to coordinate clinical determinations, documentations, and communication across care teams while interpreting criteria and policies to support members.

This remote role requires Louisiana licensure options, 3+ years of post-degree clinical and behavioral health experience, and the ability to work within a central time zone schedule; travel minimal.