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Utilization Management Behavioral Health Professional at Humana - ApplyBlast

Utilization Management Behavioral Health Professional

Humana

3 months ago

3.6 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

Humana is seeking a Utilization Management Behavioral Health Professional 2 to coordinate, document, and communicate medical services and benefit administration determinations using clinical knowledge and critical thinking. This role involves interpreting policies to ensure appropriate treatment for members while collaborating with providers and understanding organizational strategies. The position requires residing in Kentucky or contiguous states and maintaining a professional license in behavioral health or nursing.

Responsibilities

Coordinate and communicate with providers to facilitate optimal care
Interpret clinical criteria and policies for treatment determinations
Document medical services and benefit administration decisions
Apply independent critical thinking to appropriate courses of action
Collaborate with members to ensure best treatment outcomes

Skills

Qualifications

Bachelor's degree in nursingMaster's degree in Human ServicesLicensed Masters Clinical Social Worker (LCSW)Licensed Marriage and Family Therapist (LMFT)Licensed Professional Counselor (LPC)

About Humana

humana.com

Headquarters

Louisville, Kentucky, United States

Company Size

10001+ employees

Founded

1961

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