Manager, Utilization Management Behavioral Health

Humana•Work at Home - Virginia, VA

3d•Remote

About The Position

The Manager, Utilization Management Behavioral Health uses behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines and procedures. You will apply advanced technical knowledge to solve moderately complex problems. You will receive assignments in the form of goals and determines approach, resources, schedules, and goals. The Manager, Utilization Management Behavioral Health uses clinical knowledge and independent critical thinking skills. You use these skills towards interpreting criteria and procedures. The goal is to provide the best and most appropriate treatment, care, or services for members. Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment. You typically relate decisions to resources, approach, and tactical operations for projects involving own departmental area. Requires cross departmental collaboration, and will conduct briefings and area meetings; maintain frequent contact with other managers across the department. Use your skills to make an impact.

Requirements

Degree in nursing or a Master's degree in a behavioral health related field such as social work, counseling, and/or psychology, from an accredited university.
Hold a current, valid, and unrestricted license in the state of Virginia. Such licenses are: Licensed Masters Social Worker (LMSW or LMSW-ACP). They also include Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), PhD/EdD, or Registered Nurse (RN).
3 or more years of post-degree clinical experience in direct patient care required.

Nice To Haves

2 or more years of utilization management behavioral health.
1 or more years of clinical supervisory experience required, including personnel management.

Responsibilities

Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment.
Conduct briefings and area meetings.
Maintain frequent contact with other managers across the department.