Remote Behavioral Health Utilization Specialist

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

Benefits offered by this job

Remote work

Bonus eligibility

Job summary

Humana is seeking a Utilization Management Behavioral Health Professional to coordinate, document, and communicate determinations for behavioral health services in a remote Louisiana setting.

The candidate will apply clinical knowledge and independent critical thinking to interpret criteria and policies, coordinate with providers and members, and ensure the best care for Humana members while following established guidelines.

Qualifications

• Master's degree and BCBA eligibility (board-certified)
• Licensed Behavior Analyst (LBA) in KY, VA, or LA or willing to apply
• 2+ years Applied Behavior Analysis clinical experience
• Excellent verbal and written communication skills
• Working knowledge of MS Office in Windows environment

Responsibilities

• Coordinate, document, and communicate treatment determinations
• Interpret criteria, policies, and procedures for appropriate services
• Communicate with providers, members, and other parties to facilitate care
• Follow established guidelines and work with minimal direction in a remote setting

Skills

Master's degree/BCBA eligibility

LBA license in KY/VA/LA

ABA clinical experience

Strong communication skills

MS Office proficiency

Education

Master's degree in a related field

Tools

MS Office

Job description

Humana is seeking a Utilization Management Behavioral Health Professional to coordinate, document, and communicate determinations for behavioral health services in a remote Louisiana setting.

The candidate will apply clinical knowledge and independent critical thinking to interpret criteria and policies, coordinate with providers and members, and ensure the best care for Humana members while following established guidelines.