Licensed Behavioral Health UM (RN, LCSW, LMSW, LPC, LMFT, LAC)

Humana • Louisiana, MO

2d • $65,000 - $88,600 • Remote

About The Position

Become a part of our caring community and help us put health first The Licensed Behavioral Health Utilization Management Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Licensed Behavioral Health Utilization Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. This position requires residence in Louisiana. The Licensed Behavioral Health Utilization Management Professional 2 uses 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. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational 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. Follows established guidelines/procedures. Use your skills to make an impact

Requirements

• Candidates must meet one of the following licensure requirements with no history of disciplinary action: Licensed Registered Nurse (RN) – Multi-State Compact OR Master’s degree in a behavioral health–related field (Social Work, Counseling, Psychology) with a professional license from the state of Louisiana. (An additional independent Kentucky license is preferred). Licensed Clinical Social Worker (LCSW) Licensed Master Social Worker (LMSW) Licensed Professional Counselor (LPC) Licensed Marriage and Family Therapist (LMFT) Licensed Addiction Counselor (LAC) Licensed Psychologist
• Candidates must meet ALL the following: 3+ years of post-degree clinical experience in direct patient care.
• 3+ years of Behavioral Health experience
• Proficient with MS Office, navigating multiple systems and platforms and general technical skills to troubleshoot and resolve within a remote environment
• To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Behavioral Health UM experience, performing medical necessity reviews against criteria such as MCG, ASAM, InterQual.
• Managed Care, Medicaid.
• Health plan experience.

Responsibilities

• Utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.
• Uses 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.
• Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level