Utilization Management Behavioral Health Professional - Remote

Overview

Become a part of our caring community and help us put health first. Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional who utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.

In Short

• Utilize behavioral health knowledge for service coordination.
• Interpret criteria and policies to provide optimal care.
• Communicate with providers and members effectively.
• Work independently with minimal direction.
• Must reside in Kentucky or contiguous states.
• Requires a relevant bachelor's or master's degree with licensure.
• 3+ years of post-degree clinical experience required.
• Intermediate knowledge of Microsoft Office programs.
• Exceptional communication and interpersonal skills.
• Remote position with occasional travel required.

Requirements

• Bachelor’s degree in nursing or master's in Human Services.
• Professional licensure in Kentucky without disciplinary action.
• 3+ years of clinical experience in healthcare settings.
• Intermediate knowledge of Microsoft Office.
• Strong communication and interpersonal skills.
• Experience with utilization review process preferred.
• Knowledge of community health resources.
• Experience with behavioral change and health promotion.
• Knowledge of substance use disorders.

Benefits

• Competitive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability coverage.
• Life insurance and other opportunities.