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 2 who utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.

In Short

• Utilizes clinical knowledge and skills for optimal care and treatment.
• Coordinates and communicates with providers and members.
• Requires interpretation and independent determination of actions.
• Must reside in Kentucky or a contiguous county.
• Bachelor’s or Master’s degree in relevant fields.
• 2+ years experience in substance use disorder treatment.
• 3+ years post-degree clinical experience.
• Intermediate knowledge of Microsoft Office.
• Exceptional communication and interpersonal skills.
• Remote position with occasional travel required.

Requirements

• Bachelor’s degree in nursing or relevant master's degree with licensure.
• 2+ years in substance use disorder treatment.
• 3+ years clinical experience in healthcare settings.
• Knowledge of utilization review process preferred.
• Understanding of community health resources.
• Knowledge of substance use disorders and recovery.
• Exceptional oral and written communication skills.
• Ability to troubleshoot technical difficulties.
• Must work from a dedicated space to protect member information.
• Ability to build rapport with stakeholders.

Benefits

• Competitive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability.
• Life insurance and other opportunities.
• Bonus incentive plan based on performance.
• Support for personal wellness and healthcare decisions.
• Equal opportunity employer policies.
• Annual All Hands meeting travel required.
• Workdays: Monday - Friday; 8:30 AM - 5:00 PM EST.