Licensed Behavioral Health Utilization Management Professional 2

Humana Inc. · Remote Oklahoma · $65,000 - $88,600 per year · remote The Licensed Behavioral Health Utilization Management Professional 2 uses behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. This position requires residence in Oklahoma and involves using clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Responsibilities Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organisational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Requirements Meets one of the following licensure requirements with no history of disciplinary action: Licensed Registered Nurse (RN) – Multi-State Compact Master's degree in a behavioural health–related field (Social Work, Counselling, Psychology) with a professional license from the state of Oklahoma. 3+ years of post-degree clinical experience in direct patient care. 3+ years of Behavioural Health experience. Proficient with MS Office, navigating multiple systems and platforms and general technical skills to troubleshoot and resolve within a remote environment. Preferred Qualifications Behavioural Health UM experience, performing medical necessity reviews against criteria such as MCG, ASAM, InterQual. Managed Care, Medicaid. Health plan experience. Additional Information Schedule: Monday through Friday, 8:00 AM–5:00 PM Central Time. Work Location & Work Style: This is a remote position. Pay Range: $65,000 - $88,600 per year. Eligible for a bonus incentive plan. Benefits Medical, dental and vision benefits. 401(k) retirement savings plan. Time off (including paid time off, company and personal holidays, paid parental and caregiver leave). Short-term and long-term disability. Life insurance.