Remote Behavioral Health Utilization Specialist (RN/SW/PSY)

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

Benefits offered by this job

Bonus incentive plan

Remote position

Work from home

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 in a remote Louisiana-based role.

The position requires a Louisiana license or equivalent behavioral health credentials and 3+ years of post-degree clinical experience. The role emphasizes independent decision-making, policy interpretation, and cross-system collaboration for member care.

Qualifications

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

Responsibilities

• Coordinate and document medical services and benefit determinations.
• Interpret criteria, policies, and procedures to guide treatment decisions.
• Communicate with providers, members, and other stakeholders to facilitate care.

Skills

Clinical judgment

Critical thinking

Communication skills

Remote work proficiency

Education

Master's degree in behavioral health field

Louisiana professional license

RN licensure via Multi-State Compact

Tools

MS Office

Remote work platforms

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 in a remote Louisiana-based role.

The position requires a Louisiana license or equivalent behavioral health credentials and 3+ years of post-degree clinical experience. The role emphasizes independent decision-making, policy interpretation, and cross-system collaboration for member care.