Remote Licensed Behavioral Health Utilization Manager II

Humana; United (LA); Remote; USD 65,000 - 89,000; Full time

Job summary

Humana in Louisiana seeks Licensed Behavioral Health Utilization Management Professional 2 to coordinate, document, and communicate medical services and benefit determinations. This role requires clinical knowledge, independent critical thinking, and the ability to work across multiple systems in a remote environment.

Candidates must hold one of several licenses and have 3+ years of direct patient care and behavioral health experience.

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 in a remote environment

Responsibilities

• Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment.
• Interpret criteria, policies, and procedures to determine appropriate actions.
• Document medical services and benefit determinations.
• Work in a remote environment while protecting PHI / HIPAA information.

Skills

Clinical experience

Behavioral health knowledge

Independent critical thinking

MS Office proficiency

Education

RN license (Multi-State Compact)

LCSW

LMSW

LPC

LMFT

LAC

Licensed Psychologist

Master's degree in behavioral health field

Tools

MS Office

Job description

Humana in Louisiana seeks Licensed Behavioral Health Utilization Management Professional 2 to coordinate, document, and communicate medical services and benefit determinations. This role requires clinical knowledge, independent critical thinking, and the ability to work across multiple systems in a remote environment.

Candidates must hold one of several licenses and have 3+ years of direct patient care and behavioral health experience.